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Arthritis Care & Research Oct 2022To determine the incidence and worsening of lumbar spine structure and low back pain (LBP) and whether they are predicted by demographic characteristics or clinical...
OBJECTIVE
To determine the incidence and worsening of lumbar spine structure and low back pain (LBP) and whether they are predicted by demographic characteristics or clinical characteristics or appendicular joint osteoarthritis (OA).
METHODS
Paired baseline (2003-2004) and follow-up (2006-2010) lumbar spine radiographs from the Johnston County Osteoarthritis Project were graded for osteophytes (OST), disc space narrowing (DSN), spondylolisthesis, and presence of facet joint OA (FOA). Spine OA was defined as at least mild OST and mild DSN at the same level for any level of the lumbar spine. LBP, comorbidities, and back injury were self-reported. Weibull models were used to estimate hazard ratios (HRs) and 95% confidence intervals (95% CIs) of spine phenotypes accounting for potential predictors including demographic characteristics, clinical characteristics, comorbidities, obesity, and appendicular OA.
RESULTS
Obesity was a consistent and strong predictor of incidence of DSN (HR 1.80 [95% CI 1.09-2.98]), spine OA (HR 1.56 [95% CI 1.01-2.41]), FOA (HR 4.99 [95% CI 1.46-17.10]), spondylolisthesis (HR 1.87 [95% CI 1.02-3.43]), and LBP (HR 1.75 [95% CI 1.19-2.56]), and worsening of DSN (HR 1.51 [95% CI 1.09-2.09]) and LBP (HR 1.51 [95% CI 1.12-2.06]). Knee OA was a predictor of incident FOA (HR 4.18 [95% CI 1.44-12.2]). Spine OA (HR 1.80 [95% CI 1.24-2.63]) and OST (HR 1.85 [95% CI 1.02-3.36]) were predictors of incidence of LBP. Hip OA (HR 1.39 [95% CI 1.04-1.85]) and OST (HR 1.58 [95% CI 1.00-2.49]) were predictors of LBP worsening.
CONCLUSION
Among the multiple predictors of spine phenotypes, obesity was a common predictor for both incidence and worsening of lumbar spine degeneration and LBP.
Topics: Humans; Low Back Pain; Lumbar Vertebrae; Obesity; Osteoarthritis, Hip; Osteoarthritis, Spine; Osteophyte; Spondylolisthesis
PubMed: 33973412
DOI: 10.1002/acr.24643 -
Spinal Cord Series and Cases Jul 2022Ewing's sarcoma is a Primary Neuroectodermal Tumour (PNET) commonly affecting appendicular skeleton. The involvement of axial skeleton is very rare and that too of...
INTRODUCTION
Ewing's sarcoma is a Primary Neuroectodermal Tumour (PNET) commonly affecting appendicular skeleton. The involvement of axial skeleton is very rare and that too of cervical spine is rarest. We present a case of Ewing's sarcoma involving cervical spine managed surgically, and its outcome.
CASE PRESENTATION
A 26-year-old male presented with 3-month history of neck pain and progressive motor weakness for 1 week. After clinical evaluation of sign and symptoms, MRI of cervical spine revealed a posterior neck mass over C2, C3 and C4. Because of mass effect and spinal cord compression, early surgical intervention was deemed necessary to stop progression of neurological deficit and make tissue diagnosis of lesion. On histopathological examination diagnosis of Ewing sarcoma was made. PET-CT showed C2 and C3 as primary site of involvement with no other site of involvement.
DISCUSSION
The Ewing's Sarcoma of the cervical spine is a rare occurrence and usually present in late and advanced stage. High index of suspicion should be present to make early diagnosis and prevent complications.
Topics: Adult; Cervical Vertebrae; Humans; Male; Neck Pain; Positron Emission Tomography Computed Tomography; Sarcoma, Ewing; Spinal Cord Compression
PubMed: 35864101
DOI: 10.1038/s41394-022-00534-6 -
Scientific Reports Aug 2022The sternum is a stabilizing element in the axial skeleton of most tetrapods, closely linked with the function of the pectoral girdle of the appendicular skeleton.... (Review)
Review
The sternum is a stabilizing element in the axial skeleton of most tetrapods, closely linked with the function of the pectoral girdle of the appendicular skeleton. Modern mammals have a distinctive sternum characterized by multiple ossified segments, the origins of which are poorly understood. Although the evolution of the pectoral girdle has been extensively studied in early members of the mammalian total group (Synapsida), only limited data exist for the sternum. Ancestrally, synapsids exhibit a single sternal element and previously the earliest report of a segmental sternum in non-mammalian synapsids was in the Middle Triassic cynodont Diademodon tetragonus. Here, we describe the well-preserved sternum of a gorgonopsian, a group of sabre-toothed synapsids from the Permian. It represents an ossified, multipartite element resembling the mammalian condition. This discovery pulls back the origin of the distinctive "mammalian" sternum to the base of Theriodontia, significantly extending the temporal range of this morphology. Through a review of sternal morphology across Synapsida, we reconstruct the evolutionary history of this structure. Furthermore, we explore its role in the evolution of mammalian posture, gait, and ventilation through progressive regionalization of the postcranium as well as the posteriorization of musculature associated with mammalian breathing.
Topics: Biological Evolution; Fossils; Locomotion; Respiration; Sternum
PubMed: 35931742
DOI: 10.1038/s41598-022-17492-6 -
Head & Neck Jul 2018Anti-Sclerostin antibody (Scl-Ab) is a promising new bone anabolic therapy. Although anti-Scl-Ab stimulates bone formation and repair in the appendicular and axial...
BACKGROUND
Anti-Sclerostin antibody (Scl-Ab) is a promising new bone anabolic therapy. Although anti-Scl-Ab stimulates bone formation and repair in the appendicular and axial skeleton, its efficacy in the craniofacial skeleton is still poorly understood.
METHODS
Using an established model of Down syndrome-dependent bone deficiency, 10 Ts65Dn mice and 10 wild-type mice were treated weekly via i.v. tail vein injection with vehicle or anti-Sclerostin for 3 weeks and euthanized 1 week after.
RESULTS
Wild-type mice treated with the anti-Scl-Ab had increased mandibular bone, trabecular thickness, and alveolar height compared with controls. Anti-Scl-Ab increased Ts65Dn mandibular bone parameters such that they were statistically indistinguishable from those in vehicle-treated wild-type mandibles.
CONCLUSION
Treatment with anti-Scl-Ab significantly increased mandibular bone mass and alveolar height in wild type mice and normalized mandibular bone mass and alveolar height in Ts65Dn mice. The anti-Scl-Ab therapy represents a novel method for increasing mandibular bone formation.
Topics: Adaptor Proteins, Signal Transducing; Alveolar Process; Animals; Antibodies; Bone Morphogenetic Proteins; Disease Models, Animal; Glycoproteins; Intercellular Signaling Peptides and Proteins; Mandible; Mice, Mutant Strains; Osteogenesis
PubMed: 29522281
DOI: 10.1002/hed.25128 -
Proceedings of the National Academy of... Aug 2009The role of Notch signaling in cartilage differentiation and maturation in vivo was examined. Conditional Notch pathway gain and loss of function was achieved using a...
The role of Notch signaling in cartilage differentiation and maturation in vivo was examined. Conditional Notch pathway gain and loss of function was achieved using a Cre/loxP approach to manipulate Notch signaling in cartilage precursors and chondrocytes of the developing mouse embryo. Conditional overexpression of activated Notch intracellular domain (NICD) in the chondrocyte lineage results in skeletal malformations with decreased cartilage precursor proliferation and inhibited hypertrophic chondrocyte differentiation. Likewise, expression of NICD in cartilage precursors inhibits sclerotome differentiation, resulting in severe axial skeleton abnormalities. Furthermore, conditional loss of Notch signaling via RBP-J gene deletion in the chondrocyte lineage results in increased chondrocyte proliferation and skeletal malformations consistent with the observed increase in hypertrophic chondrocytes. In addition, the Notch pathway inhibits expression of Sox9 and its target genes required for normal chondrogenic cell proliferation and differentiation. Together, our results demonstrate that appropriate Notch pathway signaling is essential for proper chondrocyte progenitor proliferation and for the normal progression of hypertrophic chondrocyte differentiation into bone in the developing appendicular and axial skeletal elements.
Topics: Animals; Bone and Bones; Cartilage; Cell Differentiation; Cell Lineage; Cell Proliferation; Chondrocytes; Embryo, Mammalian; Female; Gene Expression Regulation, Developmental; Immunohistochemistry; In Situ Hybridization; Male; Mice; Osteoblasts; Receptor, Notch1; Reverse Transcriptase Polymerase Chain Reaction; Signal Transduction
PubMed: 19590010
DOI: 10.1073/pnas.0902306106 -
The Bone & Joint Journal Feb 2016The purpose of this study was to develop a prognostic model for predicting survival of patients undergoing surgery owing to metastatic bone disease (MBD) in the...
AIMS
The purpose of this study was to develop a prognostic model for predicting survival of patients undergoing surgery owing to metastatic bone disease (MBD) in the appendicular skeleton.
METHODS
We included a historical cohort of 130 consecutive patients (mean age 64 years, 30 to 85; 76 females/54 males) who underwent joint arthroplasty surgery (140 procedures) owing to MBD in the appendicular skeleton during the period between January 2003 and December 2008. Primary cancer, pre-operative haemoglobin, fracture versus impending fracture, Karnofsky score, visceral metastases, multiple bony metastases and American Society of Anaesthesiologist's score were included into a series of logistic regression models. The outcome was the survival status at three, six and 12 months respectively. Results were internally validated based on 1000 cross-validations and reported as time-dependent area under the receiver-operating characteristic curves (AUC) for predictions of outcome.
RESULTS
The predictive scores obtained showed AUC values of 79.1% (95% confidence intervals (CI) 65.6 to 89.6), 80.9% (95% CI 70.3 to 90.84) and 85.1% (95% CI 73.5 to 93.9) at three, six and 12 months.
DISCUSSION
In conclusion, we have presented and internally validated a model for predicting survival after surgery owing to MBD in the appendicular skeleton. The model is the first, to our knowledge, built solely on material from patients who only had surgery in the appendicular skeleton.
TAKE HOME MESSAGE
Applying this prognostic model will help determine whether the patients' anticipated survival makes it reasonable to subject them to extensive reconstructive surgery for which there may be an extended period of rehabilitation. Cite this article: Bone Joint J 2016;98-B:271-7.
Topics: Adult; Aged; Aged, 80 and over; Arthroplasty, Replacement; Bone Neoplasms; Denmark; Extremities; Female; Humans; Kaplan-Meier Estimate; Male; Middle Aged; Prognosis; Risk Factors
PubMed: 26850435
DOI: 10.1302/0301-620X.98B2.36107 -
Journal of Dental Research Apr 2019Osteoporosis is associated with decreased bone density and increased bone fragility, but how this disease affects alveolar bone healing is not clear. The objective of...
Osteoporosis is associated with decreased bone density and increased bone fragility, but how this disease affects alveolar bone healing is not clear. The objective of this study was to determine the extent to which osteoporosis affects the jaw skeleton and then to evaluate possible mechanisms whereby an osteoporotic phenotype might affect the rate of alveolar bone healing following tooth extraction. Using an ovariectomized mouse model coupled with micro-computed tomographic imaging, histologic, molecular, and cellular assays, we first demonstrated that the appendicular and jaw skeletons both develop osteoporotic phenotypes. Next, we demonstrated that osteoporotic mice exhibit atrophy of the periodontal ligament (PDL) and that this atrophy was accompanied by a reduction in the pool of osteoprogenitor cells in the PDL. The paucity of PDL-derived osteoprogenitor cells in osteoporotic mice was associated with significantly slower extraction socket healing. Collectively, these analyses demonstrate that the jaw skeleton is susceptible to the untoward effects of osteoporosis that manifest as thinner, more porous alveolar bone, PDL thinning, and slower bone repair. These findings have potential clinical significance for older osteopenic patients undergoing reconstructive procedures.
Topics: Alveolar Process; Animals; Humans; Mice; Osteoporosis; Periodontal Ligament; Periodontium; Wound Healing
PubMed: 30626268
DOI: 10.1177/0022034518818456 -
Nutrients Dec 2018This study sought to evaluate the associations between changes in glycemic status and changes in total body (TB), trunk, and appendicular fat (FM) and lean mass (LM) in...
This study sought to evaluate the associations between changes in glycemic status and changes in total body (TB), trunk, and appendicular fat (FM) and lean mass (LM) in men. A population-based study of men aged 20⁻66 years at baseline were included in cross-sectional ( = 430) and three-year longitudinal ( = 411) analyses. Prediabetes was defined as fasting glucose 100⁻125 mg/dL. Type 2 diabetes (T2D) was determined by: self-reported diabetes, current anti-diabetic drug use (insulin/oral hypoglycemic agents), fasting glucose (≥126 mg/dL), or non-fasting glucose (≥200 mg/dL). Body composition was evaluated by dual-energy X-ray absorptiometry. Longitudinal analyses showed that changes in TB FM and LM, and appendicular LM differed among glycemic groups. Normoglycemic men who converted to prediabetes lost more TB and appendicular LM than men who remained normoglycemic (all, < 0.05). Normoglycemic or prediabetic men who developed T2D had a greater loss of TB and appendicular LM than men who remained normoglycemic (both, < 0.05). T2D men had greater gains in TB FM and greater losses in TB and appendicular LM than men who remained normoglycemic (all, < 0.05). Dysglycemia is associated with adverse changes in TB and appendicular LM.
Topics: Adult; Aged; Blood Glucose; Body Composition; Cross-Sectional Studies; Humans; Longitudinal Ligaments; Male; Middle Aged; Young Adult
PubMed: 30513871
DOI: 10.3390/nu10121878 -
Scientific Reports Oct 2022The current prognosis for successful return to function in koalas with appendicular fractures is poor despite being the most common fracture type to result in successful...
The current prognosis for successful return to function in koalas with appendicular fractures is poor despite being the most common fracture type to result in successful rehabilitation. The forelimb, particularly the humerus, plays a critical role in stabilisation and support while climbing trees. Successful rehabilitation therefore requires adequate internal stabilisation to promote bone healing and faster return to function. Current knowledge of koala limb bone morphometry is lacking and would provide useful clinical insight for future orthopaedic research, particularly with regards to recommendations regarding implant size and type. In this study microcomputed tomography (micro-CT) was used to describe bone length, internal and external diameters, and cortical thickness at five transverse levels along the humerus of skeletally mature koala cadavers. Qualitative descriptions were also made regarding bone features deemed clinically relevant to potential fracture repair techniques. Mean humeral length was 114.3 mm (95% CI 107.29-121.31 mm). Mediolateral diameters were greater than craniocaudal diameters at each measurement level, and the diaphysis has a distally tapering medullary cavity. Diaphyseal cortices were relatively homogenous with slight distal thickening, and medial cortices were thickest along the entire bone. The bone protuberances of the deltoid and supinator ridges projected most of the way down the lateral surface of the bone while the medial surface remained relatively uniform. Distal to the deltoid ridge the humerus curved caudally, terminating at a craniocaudally flattened distal epiphysis. Morphometric descriptions provided in this study will serve as a useful reference for future research, guiding orthopaedic surgery and improving prognosis of koala humeral fractures.
Topics: Animals; Humans; X-Ray Microtomography; Phascolarctidae; Humerus; Humeral Fractures; Diaphyses
PubMed: 36302878
DOI: 10.1038/s41598-022-22944-0 -
Scientific Reports Dec 2016Hematopoietic stem cells (HSCs) in the endosteum of mesoderm-derived appendicular bones have been extensively studied. Neural crest-derived bones differ from...
Hematopoietic stem cells (HSCs) in the endosteum of mesoderm-derived appendicular bones have been extensively studied. Neural crest-derived bones differ from appendicular bones in developmental origin, mode of bone formation and pathological bone resorption. Whether neural crest-derived bones harbor HSCs is elusive. Here, we discovered HSC-like cells in postnatal murine mandible, and benchmarked them with donor-matched, mesoderm-derived femur/tibia HSCs, including clonogenic assay and long-term culture. Mandibular CD34 negative, LSK cells proliferated similarly to appendicular HSCs, and differentiated into all hematopoietic lineages. Mandibular HSCs showed a consistent deficiency in lymphoid differentiation, including significantly fewer CD229 + fractions, PreProB, ProB, PreB and B220 + slgM cells. Remarkably, mandibular HSCs reconstituted irradiated hematopoietic bone marrow in vivo, just as appendicular HSCs. Genomic profiling of osteoblasts from mandibular and femur/tibia bone marrow revealed deficiencies in several HSC niche regulators among mandibular osteoblasts including Cxcl12. Neural crest derived bone harbors HSCs that function similarly to appendicular HSCs but are deficient in the lymphoid lineage. Thus, lymphoid deficiency of mandibular HSCs may be accounted by putative niche regulating genes. HSCs in craniofacial bones have functional implications in homeostasis, osteoclastogenesis, immune functions, tumor metastasis and infections such as osteonecrosis of the jaw.
Topics: Animals; Antigens, CD; Bone Marrow Cells; Bone Marrow Transplantation; Bone and Bones; Cell Differentiation; Cell Lineage; Cell Self Renewal; Cells, Cultured; Hematopoiesis; Hematopoietic Stem Cells; Mice, Inbred C57BL; Neural Crest; Stem Cell Niche; Transcriptome
PubMed: 28000662
DOI: 10.1038/srep36411