Hypertrophy of the ligamentum flavum in lumbar spinal canal stenosis is associated with abnormal accumulation of specific lipids

Tomohiro Yamada,Tomohito Sato,Makoto Horikawa,Yu Yamato,Tomohiko Hasegawa,Go Yosida,Hiroki Ushirozako,Kenta Kurosu,Shin Oe,Yukihiro Matsuyama,Tomoaki Kahyo,Yuki Mihara,Hideyuki Arima,Md Al Mamun,Tomohiro Banno,Yusuke Takanashi,Mitsutoshi Setou

doi:10.1038/s41598-021-02818-7

Abstract

Ligamentum flavum hypertrophy (HLF) is the most important component of lumbar spinal canal stenosis (LSCS). Analysis of hypertrophied ligamentum flavum (HLF) samples from patients with LSCS can be an important que. The current study analyzed the surgical samples of HLF samples in patients with LCSC using quantitative and qualitative high performance-liquid chromatography and mass spectrometry. We collected ligamentum flavum (LF) tissue from twelve patients with LSCS and from four patients with lumbar disk herniation (LDH). We defined LF from LSCS patients as HLF and that from LDH patients as non-hypertrophied ligamentum flavum (NHLF). Total lipids were extracted from the LF samples and evaluated for quantity and quality using liquid chromatography and mass spectrometry. The total lipid amount of the HLF group was 3.6 times higher than that of the NHLF group. Phosphatidylcholines (PCs), ceramides (Cers), O-acyl-ω-hydroxy fatty acids (OAHFAs), and triglycerides (TGs) in the HLF group were more than 32 times higher than those of the NHLF group. PC(26:0)+H+, PC(25:0)+H+, and PC(23:0)+H+ increased in all patients in the HLF group compared to the NHLF group. The thickness of the LF correlated significantly with PC(26:0)+H+ in HLF. We identified the enriched specific PCs, Cers, OAHFAs, and TGs in HLF.

Highlights

BC ChemistryPatients Age Height Weight BMI Complication of DM LF thickness WBC (/μL) Hgb (g/dL) Hct (%) Plt (×104/μL) TP (g/dL) ALB (g/dL) T-Bil (g/dL) AST (U/L) ALT (U/L) γ-GTP (U/L) ALP (U/L) BUN (g/dL) Cre (g/dL) T-chol TG P value† 0.98lipids accumulating in hypertrophied ligamentum flavum (HLF) might yield an intervention for lumbar spinal canal stenosis (LSCS) other than the surgical technique
Preoperative patient background information, laboratory data, and the thickness of LF are shown in Table 1 for both the HLF and non-hypertrophied ligamentum flavum (NHLF) groups
Analysis of Magnetic resonance imaging (MRI) images revealed that the thickness of LF in the HLF group was two-times higher than that in the NHLF group (P < 0.01; Fig. 1)

Summary

Introduction

Patients (male) Age (years) Height (cm) Weight (kg) BMI Complication of DM LF thickness (mm) WBC (/μL) Hgb (g/dL) Hct (%) Plt (×104/μL) TP (g/dL) ALB (g/dL) T-Bil (g/dL) AST (U/L) ALT (U/L) γ-GTP (U/L) ALP (U/L) BUN (g/dL) Cre (g/dL) T-chol (mg/dL) TG (mg/dL) P value† 0.98. Lipids accumulating in HLF might yield an intervention for LSCS other than the surgical technique. This study aimed to analyze and quantify the lipids accumulating in HLF using lipidomics technologies. We show an increase in total lipid accumulation and in the levels of specific phosphatidylcholines (PCs), ceramides (Cers), O-acyl-ω-hydroxy fatty acids (OAHFAs), and triglyceride (TGs) in HLF

Objectives

Methods

Results

Conclusion