The proposed study focuses on understanding and developing new methods to diagnose low back pain problems resulting from both segmental instability and degenerative changes in intervertebral discs and/or facets. In the ongoing study, we found that a relationship exists between the severity of intervertebral disc degeneration and increases in torsional and flexion-extension movements. Significant differences were found in facet degeneration and disc degeneration between the asymptomatic and the symptomatic subjects. However, the mechanistic relationship between disc degeneration and the facet joint remains to be clarified. In Project 1 of the renewal Program Project Grant, we will define kinematic hypermobility in torsion and flexion-extension in vivo and correlate those measurements with low back pain symptoms. We will identify factors of prognostic importance to the progression of disc and facet joint degeneration and symptoms. We propose a five-year study of the in vivo relationship of degenerative changes with segmental instability of the lumbar spine. In this proposed study, we will re-evaluate, over a five-year interval, 25 asymptomatic normal subjects and 25 age- and sex-matched symptomatic subjects, who were investigated in the current grant cycle. Hypotheses that we will test in this study are (1) that greater segmental mobility and/or specific kinematic patterns contribute to accelerated intervertebral disc and facet degeneration over time, and (2) that load transmission through the facet joints depends on the loading direction and intervertebral disc degeneration and height, and motion segment level and facet orientation.
The specific aims are (1) to measure changes in rotational and flexion/extension segmental movement associated with disc and facet degeneration over five years within each subject (a longitudinal in vivo study comparing normal subjects and mechanical low back pain subjects), and (2) to investigate, using cadaveric lumbar spines, relationships among disc degeneration and height, segmental movement, disc pressure and facet joint pressure, and to analyze correlations between altered kinematics and load transmission (an experimental in vitro study). The outcome from the proposed study is expected to be equally effective for diagnosis of cervical spinal instability and evaluating many of new motion preservation treatment alternatives in use or under development.

Agency
National Institute of Health (NIH)
Institute
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
Type
Research Program Projects (P01)
Project #
5P01AR048152-09
Application #
7915744
Study Section
Special Emphasis Panel (ZAR1)
Project Start
2009-09-01
Project End
2011-08-31
Budget Start
2009-09-01
Budget End
2010-08-31
Support Year
9
Fiscal Year
2009
Total Cost
$174,097
Indirect Cost
Name
Rush University Medical Center
Department
Type
DUNS #
068610245
City
Chicago
State
IL
Country
United States
Zip Code
60612
Louie, Philip K; Espinoza Orías, Alejandro A; Fogg, Louis F et al. (2018) Changes in Lumbar Endplate Area and Concavity Associated With Disc Degeneration. Spine (Phila Pa 1976) 43:E1127-E1134
Basques, Bryce A; Espinoza Orías, Alejandro A; Shifflett, Grant D et al. (2017) The Kinematics and Spondylosis of the Lumbar Spine Vary Depending on the Levels of Motion Segments in Individuals With Low Back Pain. Spine (Phila Pa 1976) 42:E767-E774
Espinoza Orías, Alejandro A; Mammoser, Nicole M; Triano, John J et al. (2016) Effects of Axial Torsion on Disc Height Distribution: An In Vivo Study. J Manipulative Physiol Ther 39:294-303
Yamaguchi, Tomonori; Goto, Shota; Nishigaki, Yasuhiro et al. (2015) Microstructural analysis of three-dimensional canal network in the rabbit lumbar vertebral endplate. J Orthop Res 33:270-6
Munns, Justin J; Lee, Joe Y B; Espinoza Orías, Alejandro A et al. (2015) Ligamentum flavum hypertrophy in asymptomatic and chronic low back pain subjects. PLoS One 10:e0128321
Gregory, Diane E; Bae, Won C; Sah, Robert L et al. (2014) Disc degeneration reduces the delamination strength of the annulus fibrosus in the rabbit annular disc puncture model. Spine J 14:1265-71
Qasim, Muhammad; Natarajan, Raghu N; An, Howard S et al. (2014) Damage accumulation location under cyclic loading in the lumbar disc shifts from inner annulus lamellae to peripheral annulus with increasing disc degeneration. J Biomech 47:24-31
Chee, Ana V; Ren, Jing; Lenart, Brett A et al. (2014) Cytotoxicity of local anesthetics and nonionic contrast agents on bovine intervertebral disc cells cultured in a three-dimensional culture system. Spine J 14:491-8
Senoo, Issei; Espinoza Orías, Alejandro A; An, Howard S et al. (2014) In vivo 3-dimensional morphometric analysis of the lumbar foramen in healthy subjects. Spine (Phila Pa 1976) 39:E929-35
Simon, Peter; Espinoza Orías, Alejandro A; Andersson, Gunnar B J et al. (2012) In vivo topographic analysis of lumbar facet joint space width distribution in healthy and symptomatic subjects. Spine (Phila Pa 1976) 37:1058-64

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