Lumbar Osteoarthritis Research Articles

Lumbar Osteoarthritis in Patients with Osteoporosis Evaluated with the Lane and Wilke Scale and its Effect on Dexa Scores

Objective: This study aimed to compare bone mineral density (BMD) values in patients with lumbar osteoarthritis (OA) with and without osteoporosis (OP). This study evaluated the effect of lumbar osteoarthritis in patients with osteoporosis on Dexa scores using the Lane and Wilke scale.Methods: A total of 51 individuals with OA, 20 with OP, and 31 without OP were included in the study. Lumbar osteoarthritis was assessed and recorded using the Lane and Wilke scale. BMD was measured by dual-energy X-ray absorptiometry (DEXA) at the waist and hip (femoral neck, lumbar vertebrae). Frax assessed the risk of osteoporosis and fracture risk.Results: The mean age of patients with OP was 68.1±8.2 years, and the mean age of patients without OP was 68.6±9.4 years. There was a significant decrease between the lumbar vertebrae and femoral neck BMD values of the two groups in favor of the osteoporosis group. The t-scores of the OP group were significantly lower (p = 0.045). All variables showed a statistically significant difference between the group with OP and those without OP (p<0.05). The median values of L1-L2, L2-L3, L3-L4, and total L1-L4 were higher in absolute value in the group with OP. In frax hip and frax primary osteoporosis, the median values were higher in the group with OP than in the group without OP (p = 0.023/p = 0.020). All L1-L2, L2-L3, and L3-L4 dexa parameters with and without OP were not significantly different between the groups according to the Lane and Wilke classification (p > 0.05).Conclusion: There was no statistically significant difference between DEXA parameters in osteoporosis and non-osteoporosis patients with low back osteoarthritis (according to the Lane and Wilke classification).

Bushen Huoxue decotion-containing serum prevents chondrocyte pyroptosis in a m6A-dependent manner in facet joint osteoarthritis

BackgroundFacet joint osteoarthritis (FJOA) is a common lumbar osteoarthritis characterized by degeneration of small joint cartilage. Bushen Huoxue decotion (BSHXD) has good therapeutic effects on OA. Our work aimed to further probe the pharmacological effects of BSHXD-containing serum (BSHXD-CS) on FJOA and define underlying the mechanisms invovled. MethodsTo establish a FJOA cell model, primary rat chondrocytes were treated with LPS. The mRNA and protein expressions were assessed using qRT-PCR and western blot, respectively. The secretion levels of pro-inflammatory cytokines were measured by ELISA. Cell viability was determined by CCK8 assay. The global m6A level was detected by the kit, and NLRP3 mRNA m6A level was determined by Me-RIP assay. The molecular interactions were analyzed by RIP and RNA pull-down assays. ResultsBSHXD-CS treatment relieved LPS-induced cell injury, inflammation, NLRP3 inflammasome and pyroptosis in chondrocytes (all p < 0.05). LPS-induced NLRP3 upregulation in chondrocytes was related to its high m6A modification level (p < 0.05). It was also observed that BSHXD-CS reduced LPS-induced m6A modification in chondrocytes via repressing STAT3 (all p < 0.05), suggesting BSHXD-CS could repress NLRP3 expression via m6A-dependent manner. Moreover, DAA, a m6A specific inhibitor, was proved to strengthen the protectively roles of BSHXD-CS on LPS-challenged pytoptosis (all p < 0.05). ConclusionBSHXD-CS inhibited NLRP3 inflammasome activation and pyroptosis in chondrocytes to repress OA progression by reducing RNA m6A modification.

Contribution of Physical Therapy to the Management of the Lumbar Osteoarthritis: About 62 Cases at the Teaching Hospital of Point G

Introduction: osteoarthritis is a degenerative process of the lumber spine [2]. Objective: the overall objective of this study was to determine the frequency of lumber osteoarthrosis and the contribution of physical therapy to its management. Patients and Method: we conducted a prospective longitudinal study over two [2]. years, from October first, 2021, to September 30th, 2023, in patients seen in the physiotherapy department of the Teaching Hospital of Point G for lumbar spine osteoarthrosis. Results: sixty-two (62) patients accepted to participate in this study with female predominating up to 66.1% (n=41). The age range was from 60 to 69-year-old in 24%. Paresis was found in 24.2% as neurological sign. Forty nine percent of the patients was found with obesity. All the participants underwent a CT scan to set the lesional diagnosis. Sickle cell disease was found in 4.8% (n=3). Physical therapy sessions sere from 10 to 45. Ninety-five point 2 percents of the patients had a distinctively clinical amelioration and 61.3% with no pain anymore according to the Visual Analog Scale (VAS). There was quite a statistical significance between the VAS and symptoms amelioration. This attest that physical therapy has a significant contribution in the caring process of lumbar osteoarthritis. Conclusion: physiotherapy supplement the management of lumbar osteoarthritis. Is must therefore be associated with the medical treatment of this condition.

DOES TOTAL HIP ARTHROPLASTY SHOW A HIGHER FAILURE RATE IN PATIENTS WITH FEMORAL HEAD OSTEONECROSIS COMPARED WITH PRIMARY OSTEOARTHRITIS? A SURVIVAL ANALYSIS OF 2,464 HIPS FROM A SINGLE INSTITUTION

Results in patients undergoing total hip arthroplasty (THA) for femoral head osteonecrosis (ON) when compared with primary osteoarthritis (OA) are controversial. Different factors like age, THA type or surgical technique may affect outcome. We hypothesized that patients with ON had an increased revision rate compared with OA. We analysed clinical outcome, estimated the survival rate for revision surgery, and their possible risk factors, in two groups of patients.In this retrospective cohort analysis of our prospective database, we assessed 2464 primary THAs implanted between 1989 and 2017. Patients with OA were included in group 1, 2090 hips; and patients with ON in group 2, 374 hips. In group 2 there were more men (p&lt;0.001), patients younger than 60 years old (p&lt;0.001) and with greater physical activity (p&lt;0.001). Patients with lumbar OA (p&lt;0.001) and a radiological acetabular shape type B according to Dorr (p&lt;0.001) were more frequent in group 1. Clinical outcome was assessed according to the Harris Hip Score and radiological analysis included postoperative acetabular and femoral component position and hip reconstruction. Kaplan-Meier survivorship analysis was used to estimate the cumulative probability of not having revision surgery for different reasons. Univariate and multivariate Cox regression models were used to assess risk factors for revision surgery.Clinical improvement was better in the ON at all intervals. There were 90 hips revised, 68 due to loosening or wear, 52 (2.5%) in group 1, and 16 (4.3%) in group 2. Overall, the survival rate for revision surgery for any cause at 22 years was 88.0 % (95% CI, 82-94) in group 1 and 84.1% (95% CI, 69 – 99) in group 2 (p=0.019). Multivariate regression analysis showed that hips with conventional polyethylene (PE), compared with highly-cross linked PEs or ceramic-on-ceramic bearings, (p=0.01, Hazard Ratio (HR): 2.12, 95% CI 1.15-3.92), and cups outside the Lewinnek´s safe zone had a higher risk for revision surgery (p&lt;0.001, HR: 2.57, 95% CI 1.69-3.91).Modern highly-cross linked PEs and ceramic-on-ceramic bearings use, and a proper surgical technique improved revision rate in patients undergoing THA due to ON compared with OA.

Designing a Mobile Phone Application for Self-Management of Knee and Lumbar Osteoarthritis: A Usability and Feasibility Study

Aim: This study aims to outline the major phases involved in developing a mobile app for self-management of knee and lumbar osteoarthritis.&#x0D; Method: This developmental research had three phases, including, content selection, application design and development, and evaluation. First, a questionnaire was created based on the literature review, and its content validity index (CVI) and content validity ratio (CVR) were measured by 15 specialists. To approve the contents of the app, the 15 rheumatologists used the Delphi technique. The application was designed using Android programming tools after the content was selected. SQLite was also used to develop a database. Finally, 12 patients evaluated the application's usability through the questionnaire for user interaction satisfaction (QUIS).&#x0D; Results: Based on the rheumatologists' preferences for information content and format, 45 key data elements were specified in 8 sections. The application was then built, which included six primary modules: medical records, educational information, disease management, record activities, reminders, and reporting. Finally, the application's usability was praised (7.56 out of 9). The application was updated with the necessary improvements based on user feedback following the evaluation.&#x0D; Conclusions: app evaluating is currently underway to verify the application's usability and feasibility, and its effect on osteoarthritis outcomes linked to pain control and physical activity will be investigated in future studies.

Upregulation of P2Y12 inhibits chondrocyte apoptosis in lumbar osteoarthritis through the PI3K/AKT signaling pathway.

Lumbar facet osteoarthritis (FJOA) is a major cause of severe lower back pain and disability worldwide. However, the mechanism underlying cartilage degeneration in FJOA remains unclear. The purpose of this study was to investigate the regulation and mechanism of P2Y12 on chondrocyte apoptosis in FJOA. The experimental rats were randomly divided into non-operation (n = 20) and operation groups (n = 20). In the operation group, Sodium iodoacetate (MIA, Sigma, 200mg/mL) was injected into the right L4/5 facet process using a blunt nanoneedle 26 (WPI, Sarasota, FL, USA) under the control of an injection pump. The final injection volume was 5µL and the injection rate was 2µL/min. The facet joint was removed four weeks after surgery. After the operation, samples were stored at -80°C until further use, whereby the right facet joints in each group were tested. Hematoxylin and eosin (HE) and iron-red solid green staining were used to observe the degeneration of articular chondrocytes in rats. Immunohistochemistry and western blotting were used to observe the expressions of P2Y12, Matrix metalloproteinase 13 (MMP13), Collagen II (COL2), and other cartilage degeneration and apoptosis-related genes. Co-localization of P2Y12-cleaved caspase-3 in the apoptosis model was detected by dual-standard immunofluorescence staining. Apoptosis was also detected by flow cytometry and TUNEL assay.P2Y12 is highly expressed in OA cartilage tissue, and inhibits IL-1β -induced chondrocyte apoptosis through PI3K/AKT signaling pathway, thus playing a certain protective role on cartilage.

Collagen Peptides, in Association with Vitamin C, Sodium Hyaluronate, Manganese and Copper, as Part of the Rehabilitation Project in the Treatment of Chronic Low Back Pain.

Low back pain (LBP) is a frequent symptom. Among the causes that can determine it, lumbar osteoarthritis plays an important role. Therapeutic exercise, according to McKenzie method, has been shown to be effective in the treatment of LBP. Oral supplementation with collagen peptides represents a new therapeutic possibility in osteoarthritis. The aim of this study is to evaluate the combined efficacy of therapeutic exercise and oral administered viscosupplements in the treatment of osteoarthritis-related chronic LBP. Sixty patients were recruited and randomly divided into two groups (Group A and B). Group A performed only kinesitherapy, Group B carried out the same kinesitherapy combined with the daily administration of food supplements such as Fortigel®, Vitamin C, sodium hyaluronate, manganese and copper, during the whole treatment period. Patients were evaluated at the time of recruitment (T0), at the end of the treatment (T1 - 3 weeks after T0) and 6 weeks after T1 (T2). The outcome measures used were: Visual Analogue Scale (VAS), Oswestry Disability Index (ODI), and Short Form-12 (SF-12). All the outcomes improved significantly at T1 in both groups, but more markedly in group B. Furthermore, in group A at T2, there was a statistically significant worsening in the scores of VAS, ODI and physical component of the SF-12, while in group B, this variation has not been detected. The combination of rehabilitation based on McKenzie back exercises and oral viscosupplementation with Fortigel®, Vitamin C, sodium hyaluronate, manganese and copper represents a valid option in patients with chronic LBP, as it ensures pain relief and improvement in the quality of life and in lumbar spine functionality. These therapeutic benefits are more evident and long-lasting compared to those obtained with rehabilitation alone.

SURVEY THE VISCERAL SYNDROMES ACCORDING TO TRADITIONAL MEDICINE IN PATIENTS WITH OSTEOARTHRITIS AT INTERNAL DEPARTMENT OF HUE CENTRAL HOSPITAL AND HOSPITAL OF HUE UNIVERSITY OF MEDICINE AND PHARMACY

Background: Osteoarthritis is the most common clinical musculoskeletal disease and it affects health, work capacity, life, economy and society. There are not many studies on Visceral syndromes in osteoarthritis, although Visceral syndromes play an important role in the pattern identification and treatment in traditional medicine. The aim of this study was to survey clinical and subclinical features of osteoarthritis based on modern medicine and Visceral syndromes according to traditional medicine in osteoarthritis patients. Materials and methods: A cross-sectional descriptive study on 150 patients diagnosed and receiving treatment at Hue University of Medicine and Pharmacy Hospital and Hue Central Hospital. Results: Liver and kidney yin deficiency (32.1%), liver blood deficiency (22.4%), spleen Qi deficiency (13.5%), Intense stomach fire (10.9%), kidney Qi deficiency (9.6%), heart and spleen deficiency (9.6%), kidney yang deficiency (1.9%). The common Visceral syndromes were mainly distributed in female patients over 65 years. Liver and kidney yin deficiency syndrome was more common in osteoarthritis of lumbar spine and osteoarthritis of knee. The syndrome of liver blood deficiency was found in all 3 osteoarthritis locations at similar rates. The syndrome of spleen Qi deficiency was more common in osteoarthritis of lumbar spine. Conclusion: osteoarthritis had common syndromes of liver and kidney yin deficiency, liver blood deficiency and spleen Qi deficiency. The common Visceral syndromes were mainly distributed in elderly female patients. Liver and kidney yin deficiency syndrome was more common in osteoarthritis of lumbar spine and osteoarthritis of knee Key words: osteoarthritis, Visceral syndromes, Traditional medicine.

A Cross-Sectional Study of Retired Great British Olympians (Berlin 1936\u2013Sochi 2014): Olympic Career Injuries, Joint Health in Later Life, and Reasons for Retirement from Olympic Sport

BackgroundThe relationship between Olympic career sport injury and the long-term musculoskeletal health of the elite athlete remains unclear. This study describes the lifetime prevalence of medical attention injuries that occurred during training and/or competition as part of the athlete’s Olympic career, reasons for retirement from Olympic sport, and the point prevalence of pain and osteoarthritis (OA) among retired Great Britain’s (GB) Olympians.MethodsThis cross-sectional study involved distributing a questionnaire to retired GB Olympians who had competed at 36 Olympic Games between Berlin 1936 and Sochi 2014. The questionnaire captured Olympic career injury history (lasting ≥ 1 month), sport exposure, musculoskeletal pain (last 4 weeks), physician-diagnosed OA, and joint replacement. Injury prevalence was calculated for sports with a minimal of 15 respondents. Adjusted odds ratios (aOR) were estimated in logistic regression for pain, OA, and joint replacement. Models were adjusted for age, sex, BMI, and career duration.ResultsSix hundred fifty (57.8% male; 42.2% female) retired athletes representing 40 sports (29 summer; 11 winter), aged 60.5 years (range 23–97), completed the questionnaire. Overall, 721 injuries (368 athletes) were self-reported equating to a lifetime Olympic career injury prevalence of 56.6%. Injury prevalence was highest in field athletics (81.0%), gymnastics (75.0%), and track athletics (67.7%). Injuries most frequently occurred at the knee (19.0%), lower back (15.4%), and shoulder (11.5%). Of those injured, 19.5% retired from sport due to injury. Pain was most prevalent at the lumbar spine (32.8%), knee (25.3%), and hip (22.5%), and OA at the knee (13.4%), hip (10.4%), and lumbar spine (4.6%). Injury was associated with pain at the hip (aOR 4.88; 95% CI, 1.87–12.72, p = 0.001), knee (aOR 2.35; 95% CI, 1.45–3.81, p = 0.001), and lumbar spine (aOR 2.53; 95% CI, 1.63–3.92, p < 0.001); OA at the hip (aOR 5.97; 95% CI, 1.59–22.47, p = 0.008) and knee (aOR 3.91; 95% CI, 2.21–6.94, p < 0.001); and joint replacement at the hip (aOR 8.71; 95% CI, 2.13–35.63, p = 0.003) and knee (aOR 5.29; 95% CI, 2.39–11.74, p < 0.001).ConclusionThe lifetime prevalence of Olympic career injury was 56.6%, with those injured more likely to self-report current pain and/or OA at the hip, knee, and lumbar spine and joint replacement at the hip and knee.

Comparing the analgesic efficacy between 100 Hz and 2 Hz electroacupuncture on patients with lumbar osteoarthritis

Chronic low back pain (CLBP) represents one of the major causes of increasing disability worldwide. Electroacupuncture with different frequencies at the Hua Tuo Jia Ji acupoints has been used to treat CLBP in patients with lumbar osteoarthritis. Basic studies demonstrate that 100 Hz or 2 Hz electroacupuncture has pain-relief effects on CLBP; however, clinical evidence for choosing which frequency is still limited. Thus, our study aims to compare the effects of 100 Hz to 2 Hz electroacupuncture for CLBP on patients with lumbar osteoarthritis. A randomized controlled trial of 124 patients with lumbar osteoarthritis at the Traditional Medicine Hospital at Ho Chi Minh City from September 2018 to July 2019. Patients were randomly allocated to either intervention group (n = 62) with a 100 Hz electroacupuncture or control group (n = 62) with 2 Hz electroacupuncture at the L2-S1 Hua Tuo Jia Ji acupoints for 14 days. Du Huo Ji Sheng Tang’s decoction was also administered in both groups. Primary trial outcomes were evaluated by the QDSA score and the proportion of patients who achieved pain relief thresholds. After 14 days of treatment, the QDSA score in the intervention group decreased significantly compared to the control group. Eighty-seven percent of patients in the intervention group had pain relief of ≥70%, and only 45% of patients in the control group had such a result. The lumbar flexion range of motion in the 100 Hz group tended to be better than in the 2 Hz group. 100 Hz electroacupuncture had superior analgesic effects on lumbar osteoarthritis to 2 Hz electroacupuncture.

The association of total body composition with trunk strength, pain and disability in patients with lumbar osteoarthritis

The association of total body composition with trunk strength, pain and disability in patients with lumbar osteoarthritis

Osteoarthritis in the Middle-Aged and Elderly in China: Prevalence and Influencing Factors.

Background: Osteoarthritis is a common joint disease, with the acceleration of the aging process in China, it has troubled the middle-aged and elderly. There have been some epidemiological studies of osteoarthritis conducted in one single site, and most of them were on knee osteoarthritis. The results varied greatly between different surveys. There was still a lack of large-scale and multicenter epidemiological studies of osteoarthritis. This paper aimed to estimate the overall prevalence of lumbar osteoarthritis, cervical osteoarthritis, hand osteoarthritis, knee osteoarthritis, and hip osteoarthritis in the middle-aged and elderly in China by summarizing the existing publications. Methods: We comprehensively searched publications on 1 January 2019 in PubMed, Web of Science, Embase, Cochrane Library, CBM, CNNI, VIP, and Wan Fang. Epidemiological publications on osteoarthritis in the middle-aged and elderly Chinese published from 2000 to 2018 were summarized and analyzed by means of systematic review and meta-analysis. Data of prevalence of osteoarthritis in five joints were extracted from the included publications. The Hoy 2012 tool was used to assess the risk of bias of included studies. Results: After performing a systematic search in eight databases and manually searching, 3058 articles were obtained, and 21 articles were included in the meta-analysis. Lumbar osteoarthritis was the most prevalent with a prevalence of 25.03% (95% CI: 0.1444–0.3562). The prevalence of knee osteoarthritis followed, which was 21.51% (95% CI: 0.1873–0.2429). The prevalence of cervical osteoarthritis was 20.46% (95% CI: 0.1244–0.2849). The prevalence of hand osteoarthritis was 8.99% (95% CI: 0.0435–0.1364). The prevalence of hip osteoarthritis was not pooled due to its lack of data. Higher prevalence of knee, hand, lumbar, and cervical osteoarthritis was seen in the female group and southern regions. The prevalence of knee and hand osteoarthritis increased with age. The prevalence of lumbar and cervical osteoarthritis increased with age. There was also a trend that the prevalence increased with age before 70 years old and slightly decreased in the oldest ages. Conclusions: The lumbar joint was the joint most prevalently affected by osteoarthritis, followed by the prevalence of knee, cervical, hand, and hip joint osteoarthritis. Women, the southern population, and the older population are more susceptible to osteoarthritis. The paucity of epidemiology data of osteoarthritis in China appeals for more population-based surveys being conducted in the future. Based on the relatively high prevalence of osteoarthritis obtained from this review, self-management and community-based management should be considered, which can provide experience from the management of hypertensions and diabetes.

Relationship of joint hypermobility with low Back pain and lumbar spine osteoarthritis

BackgroundChronic low back pain (cLBP) affects millions of Americans and costs billions. Studies suggest a link between cLBP and joint hypermobility.MethodsWe conducted cross-sectional primary analyses of joint hypermobility and cLBP, lumbar spine osteoarthritis (OA), and lumbar facet joint OA (FOA) in 3 large studies—the Generalized Osteoarthritis Study, Genetics of Generalized Osteoarthritis Study, and Johnston County Osteoarthritis Project (total n = 5072). Associations of joint hypermobility and Beighton trunk flexion with cLBP and lumbar OA were estimated using separate adjusted logistic regression models. Adjusted pooled odds ratios (pORs) and 95% confidence intervals (CIs) were then summarized—using random effect univariate, multivariate crude, and adjusted models—and heterogeneity was determined (I2 statistic).ResultsIn univariate models, hypermobility was associated with symptomatic FOA (pOR = 0.64 [95% CI 0.44, 0.93]) but this result was not found in the multivariate models. In multivariate adjusted models, hypermobility was not significantly associated with cLBP and lumbar OA, but trunk flexion was inversely associated with cLBP (pOR = 0.40 [95% 0.26, 0.62]), spine OA (pOR = 0.66 [95% CI 0.50, 0.87]), symptomatic spine OA (pOR = 0.39 [95% CI 0.28, 0.53]), and symptomatic FOA (pOR = 0.53 [95% CI 0.37, 0.77]). Generally, between-study heterogeneity was moderate-high.ConclusionsHypermobility was not associated with cLBP or lumbar OA. The inverse association of trunk flexion with cLBP and lumbar OA may indicate a role for a flexible spine in avoiding or managing these conditions.

The role of body mass index (BMI), serum estrogen level and bone mineral density (BMD) in lumbar osteoarthritis and low back pain in postmenopausal women

The present study aimed to assess the role of BMI, estrogen level and BMD in lumbar osteoarthritis and lower back pain in postmenopausal women.Material and Methods: The present study is a prospective study carried out in the department of Orthopedics, Ananta Institute of Medical Sciences, Rajsamand, Rajasthan during the period of 1 year from April 2018 to April 2019. It includes 70 postmenopausal women, aged 50-75 years attended orthopaedic department with the complaint of low backache for at least 3 months. 70 premenopausal healthy women aged 25-45 years were also included in the study as control group. BMI, serum estrogen level and BMD were measured in both the groups and compared.Results: Age of the patient’s ranges from 50 to 75 years with the mean age of 62.9±5.6 years. The average post-menopausal period was 8.7 years. Mean body mass index calculated was 26.3±1.6 kg/m2 in postmenopausal group and was 24.1±1.2 in controls. Mean estrogen level was 23.9±4.6 pg/mL in postmenopausal women and 141.8±11.6 pg/mL in controls. Mean Lumbar (L1-L4) bone mineral density was 0.856±0.181 g/cm2 in postmenopausal group and 1.147±0.153 g/cm2 in controls. Out of 70 patients, 61 (87.14%) patients were having changes of lumbar OA in x-ray while 9 patients (12.85%) were having normal lumbosacral x-ray finding. None of the controls were having changes of osteoarthritis.Conclusion: Postmenopausal stage of life is associated with increased incidence of low back pain. Low estrogen level, Increased BMI and low BMD are the factors, significantly correlated with the occurrence of lumbar osteoarthritis and lower back pain in postmenopausal women

High IL-6 level as a marker of lumbar osteoarthritis in patients older than 55 years with low back pain.

BackgroundLow back pain (LBP) is a common clinical condition encountered by most physicians, but the cause and risk factors are still unclear. Cytokines such as IL-6 play an important role in cartilage degeneration, but the role of IL-6 in osteoarthritis (OA) is still debatable. Herein, we aimed to determine the association between high IL-6 levels and lumbar OA in patients older than 55 years with LBP.MethodThis was a case–control study. Patients included 10 men and 14 women over 55 years of age with lumbar OA. The control group comprised 10 men and 14 women over 55 years of age without lumbar OA. IL-6 analysis was performed for all study subjects.ResultThe mean age of patients in the case group for both men and women were 67.7±10.4 and 74.4±10.5 years, while that of the control group for both men and women were 67.7±6.3 and 64.9±6.1 years, respectively. Body mass index was not statistically significantly different between the two groups (men and women). Chi-squared analysis showed no statistically significant differences between nutritional status and lumbar OA.ConclusionThe probability of lumbar OA in LBP patients with high IL-6 levels (>6.60 pg/ mL) is five times greater than in those with low IL-6 levels (P=0.009). Women with high IL-6 levels have a 6.9-times greater probability of developing lumbar OA than men (P=0.03).

Elevated High-Sensitivity C-Reactive Protein And Interleukin-6 Plasma As Risk Factors For Symptomatic Lumbar Osteoarthritis In Postmenopausal Women.

AIM:To determine whether elevated high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), and erythrocyte sedimentation rate (ESR), as risk factors of symptomatic lumbar osteoarthritis (OA) in estrogen deficiency postmenopausal women.METHODS:A case-control study was conducted between January and June 2017. The inclusion criteria include post-menopausal women with estrogen deficiency with low back pain. Exclusion criteria were: patients with a history of undergoing bilateral oophorectomy, taking hormonal replacement therapy or corticosteroid, malignancies, and lumbosacral spine trauma. The blood examinations were taken to measure IL-6 level by ELISA, hs-CRP level by spectrophotometry and ESR by modified Westergren method.RESULTS:A group of 44 pairs of subjects were divided equally into case and control groups showed that in estrogen deficiency postmenopausal women, an increased level of hs-CRP increased the risk for symptomatic lumbar OA (OR = 2.83, CI95% = 1.065-8.776, p = 0.034). Also, a high level of IL-6 increased the risk of symptomatic lumbar OA (OR = 2.7, CI95% = 0.991-8.320, p = 0.033). No such significant findings were found for an increased ESR level.CONCLUSION:Elevated level of plasma hs-CRP and IL-6 were concluded as risk factors for symptomatic lumbar OA in post-menopausal women.

Abatacept might increase bone mineral density at femoral neck for patients with rheumatoid arthritis in clinical practice: AIRTIGHT study

We investigated the influence of abatacept (ABT) on bone mineral density (BMD) and bone metabolic markers (BMMs) in patients with rheumatoid arthritis (RA) compared to other biologic disease-modifying anti-rheumatic drugs (bDMARDs). This prospective, comparative, non-randomized study (the AIRTIGHT study; UMIN000005570) investigated the effects of ABT and other bDMARDs on bone metabolism. A total of 165 RA patients were divided into ABT (n = 50) and non-ABT (n = 115). We evaluated percentage changes in BMD (%ΔBMD) at the lumbar spine and femoral neck using dual-energy X-ray absorptiometry. Urinary levels of cross-linked N-telopeptide of type I collagen (uNTx) and bone-specific alkaline phosphatase (BAP) were used as markers of bone resorption and formation, respectively. No significant differences in 1-year completion rates were seen between ABT (64%) and non-ABT (72%; p = 0.387). The %ΔBMD at the femoral neck was significantly higher in the ABT group (0.97%) than in the non-ABT group (- 2.19%; p = 0.026). Whereas, no significant difference in %ΔBMD at the lumbar spine was observed between groups (ABT, - 0.40%; Non-ABT, - 1.67%; p = 0.524). No significant differences were observed in changes to uNTx or BAP. ABT treatment was significantly associated with increased BMD at the femoral neck (odds ratio (OR) 8.84; 95% CI 1.08-72.4; p = 0.04), and baseline lumbar osteoarthritis was significantly associated with BMD at the lumbar spine (OR 2.97; 95% CI 1.23-7.13; p = 0.02). The efficacy of ABT for increasing BMD at the femoral neck was superior to that of other bDMARDs. ABT may offer good efficacy for improving BMD at the femoral neck in patients with RA.

Effects of Defensive Style Nordic Walking Intervention in Patients with Lumbar and Lower-Limb Osteoarthritis

Regular exercise is effective for improving physical functions and pain relief in patients with lumbar and lowerlimb osteoarthritis. However, some of the patients have difficulty in performing land-based exercises due to disease status. This study focused on defensive style Nordic walking as a land-based exercise the patients can perform and aimed to investigate the effects of defensive style Nordic walking intervention on functional performance and pain in patients with lumbar and lower-limb osteoarthritis with low walking capacity. After 10 weeks of non-intervention, thirteen patients participated in the defensive style Nordic walking intervention for 10 weeks. The sixty-minute Nordic walking exercise was conducted once a week. Self-reported maximum walking distance without a break of the patients was less than 1 km and eight patients usually use a cane while walking. Functional performance measurement was conducted before non-intervention, after non-intervention (before intervention), and after intervention periods. Pain was measured using visual analog scale before and after each exercise session. Indices to estimate mobility, lower-limb muscle strength, and balance ability were improved by the intervention as compared with the non-intervention. Pain score decreased immediately after one session of defensive style Nordic walking and throughout the intervention period. These results suggest that the defensive style Nordic walking is an effective landbased exercise to improve mobility, lower-limb muscle strength, balance, and pain relief in patients with lumbar and lower-limb osteoarthritis with low walking capacity.

Morphometric Study of the Lumbar Spray in the African Black West Subject: Interest in Surgery. About a CT Scans of 170 Cases in Ouagadougou (Burkina Faso)

Objective: Our study aimed at analyzing the morphometry of the lumbar spine at the CT scan and to specify its interest in spinal surgery. Methodology: This was a prospective study conducted from May 1, 2011 to July 31, 2011 in Ouagadougou. During this study, 170 patients aged 45.3 ± 12.5 years old with a sex ratio of 1.15 received a CT scan. The symptomatology was dominated by low back pain (60.6%) and lumbar osteoarthritis was the most common etiology (51.8%). The measurements were performed directly on axial and sagittal sections of the lumbar spine with measurement of the vertebral body, and pedicles. Results: The vertebral body increased forward from 24.9 mm in L1 to 26.7 mm in L5 and decreasing backwards from 26.6 mm in L1 to 23.4 mm in L5. The transverse diameter of the vertebral body ranged from 37 mm in L1 to 47.4 mm in L5 and the anteroposterior diameter of 27.6 mm in L1 to 33.5 mm in L5. The lumbar canal had an anteroposterior diameter that ranged from 15.9 mm in L1 to 15.5 mm in L5 and an interpedicular distance increasing from 21.54 mm in L1 to 28.42 mm in L5. The pedicle decreased in length from L1 (9.5 mm) to L5 (6.5 mm) while its width increased from 6.9 mm in L1 to 15.1 mm in L5. Its axis formed, with respect to the sagittal plane, an increasingly obtuse angle varying from 16.3 degrees in L1 to 29.1 degrees in L5 and with respect to the upper plate of the vertebral body, an increasingly acute angle (14, 2 degrees in L1 at 8.8 degrees in L5). Conclusion: The dimensions of the lumbar vertebrae in our series differ from those noted in Western populations in that they have a smaller vertebral body, a shorter, wider pedicle with an angle of inclination of the pedicle compared to the sagittal and horizontal planes more obtuse.

Altered Wnt and NF-κB Signaling in Facet Joint Osteoarthritis: Insights from RNA Deep Sequencing.

Facet joint osteoarthritis is common lumbar osteoarthritis characterized by facet joint cartilage degeneration. However, the molecular basis of facet joint osteoarthritis remains largely undetermined. In the current study, we collected facet joint tissue samples from 10 control patients and 48 patients with facet joint osteoarthritis (20 patients with moderate degeneration and 28 with severe degeneration). The control patients underwent internal fixation of the lumbar spine due to vertebral fracture. RNA deep sequencing was performed, and Bioinformatic tools were applied. Among top 30 enriched signaling pathways, we focused on two inflammation-related signaling pathways, Wnt and NF-κB signaling pathways. Subsequently, using the quantitative RT-PCR analysis, we confirmed that in Wnt signaling pathway, the mRNA levels of Dickkopf WNT Signaling Pathway Inhibitor 2 (DKK2), Sex-determining Region Y-box 17 (SOX17), MYC, Cyclin D1, Calcium/Calmodulin Dependent Protein Kinase II Alpha (CAMK2A), and Wnt Family Member 11 and 5 were increased in facet joint osteoarthritis, while the mRNA levels of WNT Inhibitory Factor 1, Casein Kinase 1 Alpha 1, Transcription Factor 7/Lymphoid Enhancer Binding Factor 1 (TCF7/LEF1), and VANGL Planar Cell Polarity Protein 2 were decreased. In NF-κB signaling pathway, the mRNA levels of C-C Motif Chemokine Ligand 4 (CCL4) and C-C Motif Chemokine Ligand 4 Like 2 (CCL4L2) were increased, while the mRNA levels of BCL2 Related Protein A1 were decreased. These results suggest that Wnt and NF-κB signaling may be altered in the process of facet joint cartilage degeneration. The present study will expand our understanding of the molecular bases underlying facet joint osteoarthritis.