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Liu Ning - One of the best experts on this subject based on the ideXlab platform.
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Radiological Signs of Scheuermann Disease and Low Back Pain Retrospective Categorization of 188 Hospital Staff Members With 6-Year Follow-up
spine, 2014Co-Authors: Liu Ning, Guo Xinhu, Chen Zhongqiang, Qi Qiang, Shi Wei, Guo Zhaoqing, Zeng Yan, Sun Chuiguo, Liu ZhongjunAbstract:Study Design. Retrospective cohort study. Objective. To investigate the relationship between radiological signs of Scheuermann disease (SD) and low back pain (LBP) in a local population using lumbar magnetic resonance (MR) images. Summary of Background Data. SD is a Spinal Disorder, and both its classic and atypical (lumbar) forms are associated with LBP. However, radiological signs of SD are present in 18% to 40% of the general population, in whom the clinical significance of "SD-like" spine remains largely unknown. Methods. This retrospective cohort study included 188 staff members from a single hospital. Participants' lumbar MR images and self-administered questionnaires concerning demographic information, LBP status, consequences, and functional limitations were collected. Participants were classified into 2 groups according to whether lumbar MR images met SD diagnostic criteria, and LBP status, consequences, and functional limitation were compared. Follow-up interviews were conducted after 6 years to compare LBP progression. Results. Thirty-four participants (18.1%) had SD-like spine. Rates of lifetime, previous 1-year, and point LBP did not significantly differ between groups. However, among participants who had ever had LBP, SD-like spine was associated with higher rates of work absence (42.1% vs. 9.5%, chi(2) = 9.620, P = 0.002) and seeking medical care (68.4% vs. 39.2%, chi(2) = 5.216, P = 0.022) due to LBP, as well as significantly greater intensity of the most severe LBP episode in the past 2 years (6.4 +/- 2.5 vs. 4.1 +/- 2.5, t = 3.564, P = 0.001). Among the 159 participants who completed the 6-year follow-up, a significantly higher proportion of people with SD-like spine reported aggravated LBP during the follow-up. Conclusion. Our results suggest that in the general population, lumbar MR images of many people meet SD diagnostic criteria, and having SD-like spine seemed to be associated with the severity and progressive nature of LBP. Our findings should inspire further research in this field.Clinical NeurologyOrthopedicsSCI(E)PubMed1ARTICLEzhongqiang_chen@yahoo.com201666-16753
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Comparison between two types of "Scheuermann disease-like people": thoracolumbar disc herniation patients and healthy volunteers with radiological signs of Scheuermann's disease
Chinese Medical Journal, 2014Co-Authors: Guo Xinhu, Liu Ning, Chen Zhongqiang, Qi Qiang, Guo Zhaoqing, Zeng Yan, Li Weishi, Sun ChuiguoAbstract:Background Scheuermann's disease (SD) is a Spinal Disorder and includes both a classic form and an atypical form. Interestingly, its existence among the general population as well as the disc disease patients is common. One of our previous studies showed that about 18% of the hospital staff members meet the SD criteria. On the other hand, another study has demonstrated that 95.2% of the symptomatic thoracolumbar disc herniation (STLDH) patients meet the SD criteria, which suggests that STLDH is very likely a special form of SD. The purpose of this study was to discriminate the factors contributing to the development of STLDH by comparing STLDH patients with the healthy SD-like hospital staff members. Methods This is a retrospective study including 33 STLDH patients who met the SD criteria and 30 SD-like hospital staff members. The STLDH group was chosen from a group of patients who underwent surgery after a diagnosis of STLDH (T10/11-L1/2) at our hospital between June 2007 and June 2010. SD-like hospital staff members were chosen from a database created in 2007, which contained a lumbar MR and low back pain (LBP) questionnaire of 188 hospital staff members. The demographic and radiologic characteristics were compared between groups. Results There was no statistical difference in sex, age, and height between the two groups. The STLDH patients had higher body weight, boby mass index, and thoracolumbar kyphotic angle than SD-like hospital staff members. In addition, STLDH patients had more levels of Schmorl's nodes (3.5 +/- 1.7 vs. 2.0 +/- 1.9, t=3.364, P=0.001) and irregular endplateson (4.0 +/- 1.9 vs. 2.7 +/- 1.9, t=2.667, P=0.010) compared to the SD-like hospital staff members. Conclusions Higher body weight, higher body mass index, larger thoracolumbar kyphosis, and more Schmorl's nodes and irregular endplates on MR may be associated with the development of STLDH in "SD-like people."http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000346329600006&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=8e1609b174ce4e31116a60747a720701Medicine, General & InternalSCI(E)PubMed中国科技核心期刊(ISTIC)中国科学引文数据库(CSCD)0ARTICLEpuh3_czq@bjmu.edu.cn223862-386612
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The relationship of symptomatic thoracolumbar disc herniation and Scheuermann's disease
european spine journal, 2014Co-Authors: Liu Ning, Chen Zhongqiang, Qi Qiang, Shi ZefengAbstract:Symptomatic disc herniations in the thoracolumbar spine between T10/11 and L1/2 can be collectively called thoracolumbar disc herniation (TLDH). The etiology of this Disorder is unclear. However, it is interesting that we have noted numerous TLDH patients have radiographic features of another Spinal Disorder which is Scheuermann's disease (SD). The purpose of this study is to investigate the relationship between symptomatic TLDH and SD in a symptomatic TLDH cohort. A cohort of 63 patients with symptomatic TLDH, who had surgery was investigated. Incidences of associated SD and four radiographic signs of SD that were Schmorl's node, irregular vertebral end plate, posterior bony avulsion of the vertebra and wedge-shaped vertebra, average thoracolumbar kyphotic angle and incidences of disc herniation at segments with and without radiographic signs of SD were examined. Data from the TLDH group were compared with 57 patients undergoing surgery for lower lumbar disc herniation (LDH, L3/4-L5/S1) in the same period. The incidences of the four radiographic signs of SD and the incidence of associated SD were all significantly higher in the TLDH group than in the LDH group. 95.2 % of the patients in the TLDH group were diagnosed with SD (either classical SD or its atypical form). The average thoracolumbar kyphotic angle of the TLDH group was 16.9A degrees, while that of the LDH group was 7.6A degrees (P = 0.000). In the TLDH group, the incidences of disc herniation at segments with radiographic signs of SD were all significantly higher than at segments where no sign of SD was found. The high proportion of associated SD and the tendency of SD's signs to promote disc herniation in symptomatic TLDH patients suggest a close relationship between these two Disorders. Symptomatic TLDH should be seen as a truly different surgical entity, that is, a special form of SD rather than just an indicator of a failing back.Clinical NeurologyOrthopedicsSCI(E)PubMed2ARTICLEzhongqiang_chen@yahoo.com51059-10662
Ning Liu - One of the best experts on this subject based on the ideXlab platform.
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radiological signs of scheuermann disease and low back pain retrospective categorization of 188 hospital staff members with 6 year follow up
Spine, 2014Co-Authors: Ning Liu, Xinhu Guo, Zhongqiang Chen, Zhaoqing Guo, Yan Zeng, Chuiguo Sun, Zhongjun LiuAbstract:Low back pain (LBP) is a leading debilitating Disorder worldwide,1 affecting up to 84% of the general population at some point in life.2 It not only impacts patients' quality of life and financial well-being, but also the financial health of the entire health care system.3 The majority of LBP is nonspecific, with no sign of a specific Spinal Disorder or definite underlying condition such as cancer or infection, posing difficulty for its prevention and treatment.4 Potential LBP risk factors include physiological factors (female sex,5,6 obesity,2,7 and poor health8), socioeconomic factors (smoking,2,9 heavy workload,2,6,8 and low income10), and psychological factors (work dissatisfaction10 and depression11). However, the majority of these risk factors concern outside influences that are inherently difficult to assess in an individual clinical encounter. Among intrinsic factors, some are too subtle (e.g., sex) for use in the Spinal community, whereas others are too subtle (e.g., interleukin-1 gene cluster polymorphism2) for accessibility in typical clinical settings. Magnetic resonance (MR) of the spine can provide straightforward information on disc degeneration (DD). However, current evidence on the association between DD and LBP in adult populations is generally not strong and has been controversial.2,12,13 Therefore, identifying new intrinsic risk factors of LBP that are both straightforward and acquirable in daily practice is significant to LBP investigation and management. Scheuermann disease (SD) is a Spinal Disorder named after Dr. Holger Werfel Scheuermann, who, in 1921, first described a structural thoracic kyphosis mainly affecting adolescents.14 Its best-known manifestations are multiple wedged vertebrae (WV) and thoracic kyphosis known as Scheuermann kyphosis. Its classic diagnostic criterion was “3 or more consecutive wedged thoracic vertebrae,” proposed by Sorensen in 1964.15 However, SD pathological changes also include disc and endplate lesions, primarily Schmorl node (SN) and irregular vertebral endplate (IE).14,15 Therefore, the diagnosis of “atypical SD” was proposed for patients with only one or 2 WV and no notable kyphosis, but characteristic disc/endplate lesions, including SN and IE.16–20 Because atypical SD tends to affect the lumbar or thoracolumbar junction region instead of the thoracic spine, it is also called “lumbar SD.”16,17,19,20 Thus, SD represents a broader concept than Scheuermann kyphosis (classic SD) because it also includes lumbar SD (atypical SD) (Figure (Figure1;1; Table Table11). Figure 1. What makes up “Scheuermann disease”? The definition of SD is not uniform or fixed. Instead, it depends on the form being referred to and a corresponding combination of pathological changes. Classic SD (the upper surface of the cube) is ... TABLE 1. Description of 15 Reports on the Diagnostic Criteria of Atypical (Lumbar) SD Notably, both classic SD and atypical SD are associated with back pain.14,16,17,19–22 Although Scheuermann kyphosis is uncommon, SD radiological signs have been observed in 18% to 40% of the general population,23 suggesting that SD, or more precisely, “SD-like” spine, may be a variant of normal spine morphology rather than a disease. A genetic role in the cause of SD has been proposed, with a suspected autosomal dominant pattern of inheritance.20,24 The Trp3 allele, a variant of the COL9A3 gene, has been associated with SD.20 We speculated whether an SD-like spine is associated with LBP in the general population. However, previous studies on the relationship between SD and LBP have primarily focused on patients with Scheuermann kyphosis, back pain, or sciatica. Therefore, we conducted this study to investigate the relationship between SD-like spines and LBP in a local population of hospital staff members.
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the relationship of symptomatic thoracolumbar disc herniation and scheuermann s disease
European Spine Journal, 2014Co-Authors: Ning Liu, Zhongqiang Chen, Zefeng ShiAbstract:Purpose Symptomatic disc herniations in the thoracolumbar spine between T10/11 and L1/2 can be collectively called thoracolumbar disc herniation (TLDH). The etiology of this Disorder is unclear. However, it is interesting that we have noted numerous TLDH patients have radiographic features of another Spinal Disorder which is Scheuermann’s disease (SD). The purpose of this study is to investigate the relationship between symptomatic TLDH and SD in a symptomatic TLDH cohort.
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comparison between two types of scheuermann disease like people thoracolumbar disc herniation patients and healthy volunteers with radiological signs of scheuermann s disease
Chinese Medical Journal, 2014Co-Authors: Xinhu Guo, Ning Liu, Zhongqiang Chen, Zhaoqing Guo, Yan Zeng, Chuiguo SunAbstract:BACKGROUND: Scheuermann's disease (SD) is a Spinal Disorder and includes both a classic form and an atypical form. Interestingly, its existence among the general population as well as the disc disease patients is common. One of our previous studies showed that about 18% of the hospital staff members meet the SD criteria. On the other hand, another study has demonstrated that 95.2% of the symptomatic thoracolumbar disc herniation (STLDH) patients meet the SD criteria, which suggests that STLDH is very likely a special form of SD. The purpose of this study was to discriminate the factors contributing to the development of STLDH by comparing STLDH patients with the healthy SD-like hospital staff members. METHODS: This is a retrospective study including 33 STLDH patients who met the SD criteria and 30 SD-like hospital staff members. The STLDH group was chosen from a group of patients who underwent surgery after a diagnosis of STLDH (T10/11-L1/2) at our hospital between June 2007 and June 2010. SD-like hospital staff members were chosen from a database created in 2007, which contained a lumbar MR and low back pain (LBP) questionnaire of 188 hospital staff members. The demographic and radiologic characteristics were compared between groups. RESULTS: There was no statistical difference in sex, age, and height between the two groups. The STLDH patients had higher body weight, boby mass index, and thoracolumbar kyphotic angle than SD-like hospital staff members. In addition, STLDH patients had more levels of Schmorl's nodes (3.5±1.7 vs. 2.0±1.9, t = 3.364, P = 0.001) and irregular endplateson (4.0±1.9 vs. 2.7±1.9, t = 2.667, P = 0.010) compared to the SD-like hospital staff members. CONCLUSIONS: Higher body weight, higher body mass index, larger thoracolumbar kyphosis, and more Schmorl's nodes and irregular endplates on MR may be associated with the development of STLDH in "SD-like people."
Chen Zhongqiang - One of the best experts on this subject based on the ideXlab platform.
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Radiological Signs of Scheuermann Disease and Low Back Pain Retrospective Categorization of 188 Hospital Staff Members With 6-Year Follow-up
spine, 2014Co-Authors: Liu Ning, Guo Xinhu, Chen Zhongqiang, Qi Qiang, Shi Wei, Guo Zhaoqing, Zeng Yan, Sun Chuiguo, Liu ZhongjunAbstract:Study Design. Retrospective cohort study. Objective. To investigate the relationship between radiological signs of Scheuermann disease (SD) and low back pain (LBP) in a local population using lumbar magnetic resonance (MR) images. Summary of Background Data. SD is a Spinal Disorder, and both its classic and atypical (lumbar) forms are associated with LBP. However, radiological signs of SD are present in 18% to 40% of the general population, in whom the clinical significance of "SD-like" spine remains largely unknown. Methods. This retrospective cohort study included 188 staff members from a single hospital. Participants' lumbar MR images and self-administered questionnaires concerning demographic information, LBP status, consequences, and functional limitations were collected. Participants were classified into 2 groups according to whether lumbar MR images met SD diagnostic criteria, and LBP status, consequences, and functional limitation were compared. Follow-up interviews were conducted after 6 years to compare LBP progression. Results. Thirty-four participants (18.1%) had SD-like spine. Rates of lifetime, previous 1-year, and point LBP did not significantly differ between groups. However, among participants who had ever had LBP, SD-like spine was associated with higher rates of work absence (42.1% vs. 9.5%, chi(2) = 9.620, P = 0.002) and seeking medical care (68.4% vs. 39.2%, chi(2) = 5.216, P = 0.022) due to LBP, as well as significantly greater intensity of the most severe LBP episode in the past 2 years (6.4 +/- 2.5 vs. 4.1 +/- 2.5, t = 3.564, P = 0.001). Among the 159 participants who completed the 6-year follow-up, a significantly higher proportion of people with SD-like spine reported aggravated LBP during the follow-up. Conclusion. Our results suggest that in the general population, lumbar MR images of many people meet SD diagnostic criteria, and having SD-like spine seemed to be associated with the severity and progressive nature of LBP. Our findings should inspire further research in this field.Clinical NeurologyOrthopedicsSCI(E)PubMed1ARTICLEzhongqiang_chen@yahoo.com201666-16753
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Comparison between two types of "Scheuermann disease-like people": thoracolumbar disc herniation patients and healthy volunteers with radiological signs of Scheuermann's disease
Chinese Medical Journal, 2014Co-Authors: Guo Xinhu, Liu Ning, Chen Zhongqiang, Qi Qiang, Guo Zhaoqing, Zeng Yan, Li Weishi, Sun ChuiguoAbstract:Background Scheuermann's disease (SD) is a Spinal Disorder and includes both a classic form and an atypical form. Interestingly, its existence among the general population as well as the disc disease patients is common. One of our previous studies showed that about 18% of the hospital staff members meet the SD criteria. On the other hand, another study has demonstrated that 95.2% of the symptomatic thoracolumbar disc herniation (STLDH) patients meet the SD criteria, which suggests that STLDH is very likely a special form of SD. The purpose of this study was to discriminate the factors contributing to the development of STLDH by comparing STLDH patients with the healthy SD-like hospital staff members. Methods This is a retrospective study including 33 STLDH patients who met the SD criteria and 30 SD-like hospital staff members. The STLDH group was chosen from a group of patients who underwent surgery after a diagnosis of STLDH (T10/11-L1/2) at our hospital between June 2007 and June 2010. SD-like hospital staff members were chosen from a database created in 2007, which contained a lumbar MR and low back pain (LBP) questionnaire of 188 hospital staff members. The demographic and radiologic characteristics were compared between groups. Results There was no statistical difference in sex, age, and height between the two groups. The STLDH patients had higher body weight, boby mass index, and thoracolumbar kyphotic angle than SD-like hospital staff members. In addition, STLDH patients had more levels of Schmorl's nodes (3.5 +/- 1.7 vs. 2.0 +/- 1.9, t=3.364, P=0.001) and irregular endplateson (4.0 +/- 1.9 vs. 2.7 +/- 1.9, t=2.667, P=0.010) compared to the SD-like hospital staff members. Conclusions Higher body weight, higher body mass index, larger thoracolumbar kyphosis, and more Schmorl's nodes and irregular endplates on MR may be associated with the development of STLDH in "SD-like people."http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000346329600006&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=8e1609b174ce4e31116a60747a720701Medicine, General & InternalSCI(E)PubMed中国科技核心期刊(ISTIC)中国科学引文数据库(CSCD)0ARTICLEpuh3_czq@bjmu.edu.cn223862-386612
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The relationship of symptomatic thoracolumbar disc herniation and Scheuermann's disease
european spine journal, 2014Co-Authors: Liu Ning, Chen Zhongqiang, Qi Qiang, Shi ZefengAbstract:Symptomatic disc herniations in the thoracolumbar spine between T10/11 and L1/2 can be collectively called thoracolumbar disc herniation (TLDH). The etiology of this Disorder is unclear. However, it is interesting that we have noted numerous TLDH patients have radiographic features of another Spinal Disorder which is Scheuermann's disease (SD). The purpose of this study is to investigate the relationship between symptomatic TLDH and SD in a symptomatic TLDH cohort. A cohort of 63 patients with symptomatic TLDH, who had surgery was investigated. Incidences of associated SD and four radiographic signs of SD that were Schmorl's node, irregular vertebral end plate, posterior bony avulsion of the vertebra and wedge-shaped vertebra, average thoracolumbar kyphotic angle and incidences of disc herniation at segments with and without radiographic signs of SD were examined. Data from the TLDH group were compared with 57 patients undergoing surgery for lower lumbar disc herniation (LDH, L3/4-L5/S1) in the same period. The incidences of the four radiographic signs of SD and the incidence of associated SD were all significantly higher in the TLDH group than in the LDH group. 95.2 % of the patients in the TLDH group were diagnosed with SD (either classical SD or its atypical form). The average thoracolumbar kyphotic angle of the TLDH group was 16.9A degrees, while that of the LDH group was 7.6A degrees (P = 0.000). In the TLDH group, the incidences of disc herniation at segments with radiographic signs of SD were all significantly higher than at segments where no sign of SD was found. The high proportion of associated SD and the tendency of SD's signs to promote disc herniation in symptomatic TLDH patients suggest a close relationship between these two Disorders. Symptomatic TLDH should be seen as a truly different surgical entity, that is, a special form of SD rather than just an indicator of a failing back.Clinical NeurologyOrthopedicsSCI(E)PubMed2ARTICLEzhongqiang_chen@yahoo.com51059-10662
Qi Qiang - One of the best experts on this subject based on the ideXlab platform.
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Radiological Signs of Scheuermann Disease and Low Back Pain Retrospective Categorization of 188 Hospital Staff Members With 6-Year Follow-up
spine, 2014Co-Authors: Liu Ning, Guo Xinhu, Chen Zhongqiang, Qi Qiang, Shi Wei, Guo Zhaoqing, Zeng Yan, Sun Chuiguo, Liu ZhongjunAbstract:Study Design. Retrospective cohort study. Objective. To investigate the relationship between radiological signs of Scheuermann disease (SD) and low back pain (LBP) in a local population using lumbar magnetic resonance (MR) images. Summary of Background Data. SD is a Spinal Disorder, and both its classic and atypical (lumbar) forms are associated with LBP. However, radiological signs of SD are present in 18% to 40% of the general population, in whom the clinical significance of "SD-like" spine remains largely unknown. Methods. This retrospective cohort study included 188 staff members from a single hospital. Participants' lumbar MR images and self-administered questionnaires concerning demographic information, LBP status, consequences, and functional limitations were collected. Participants were classified into 2 groups according to whether lumbar MR images met SD diagnostic criteria, and LBP status, consequences, and functional limitation were compared. Follow-up interviews were conducted after 6 years to compare LBP progression. Results. Thirty-four participants (18.1%) had SD-like spine. Rates of lifetime, previous 1-year, and point LBP did not significantly differ between groups. However, among participants who had ever had LBP, SD-like spine was associated with higher rates of work absence (42.1% vs. 9.5%, chi(2) = 9.620, P = 0.002) and seeking medical care (68.4% vs. 39.2%, chi(2) = 5.216, P = 0.022) due to LBP, as well as significantly greater intensity of the most severe LBP episode in the past 2 years (6.4 +/- 2.5 vs. 4.1 +/- 2.5, t = 3.564, P = 0.001). Among the 159 participants who completed the 6-year follow-up, a significantly higher proportion of people with SD-like spine reported aggravated LBP during the follow-up. Conclusion. Our results suggest that in the general population, lumbar MR images of many people meet SD diagnostic criteria, and having SD-like spine seemed to be associated with the severity and progressive nature of LBP. Our findings should inspire further research in this field.Clinical NeurologyOrthopedicsSCI(E)PubMed1ARTICLEzhongqiang_chen@yahoo.com201666-16753
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Comparison between two types of "Scheuermann disease-like people": thoracolumbar disc herniation patients and healthy volunteers with radiological signs of Scheuermann's disease
Chinese Medical Journal, 2014Co-Authors: Guo Xinhu, Liu Ning, Chen Zhongqiang, Qi Qiang, Guo Zhaoqing, Zeng Yan, Li Weishi, Sun ChuiguoAbstract:Background Scheuermann's disease (SD) is a Spinal Disorder and includes both a classic form and an atypical form. Interestingly, its existence among the general population as well as the disc disease patients is common. One of our previous studies showed that about 18% of the hospital staff members meet the SD criteria. On the other hand, another study has demonstrated that 95.2% of the symptomatic thoracolumbar disc herniation (STLDH) patients meet the SD criteria, which suggests that STLDH is very likely a special form of SD. The purpose of this study was to discriminate the factors contributing to the development of STLDH by comparing STLDH patients with the healthy SD-like hospital staff members. Methods This is a retrospective study including 33 STLDH patients who met the SD criteria and 30 SD-like hospital staff members. The STLDH group was chosen from a group of patients who underwent surgery after a diagnosis of STLDH (T10/11-L1/2) at our hospital between June 2007 and June 2010. SD-like hospital staff members were chosen from a database created in 2007, which contained a lumbar MR and low back pain (LBP) questionnaire of 188 hospital staff members. The demographic and radiologic characteristics were compared between groups. Results There was no statistical difference in sex, age, and height between the two groups. The STLDH patients had higher body weight, boby mass index, and thoracolumbar kyphotic angle than SD-like hospital staff members. In addition, STLDH patients had more levels of Schmorl's nodes (3.5 +/- 1.7 vs. 2.0 +/- 1.9, t=3.364, P=0.001) and irregular endplateson (4.0 +/- 1.9 vs. 2.7 +/- 1.9, t=2.667, P=0.010) compared to the SD-like hospital staff members. Conclusions Higher body weight, higher body mass index, larger thoracolumbar kyphosis, and more Schmorl's nodes and irregular endplates on MR may be associated with the development of STLDH in "SD-like people."http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000346329600006&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=8e1609b174ce4e31116a60747a720701Medicine, General & InternalSCI(E)PubMed中国科技核心期刊(ISTIC)中国科学引文数据库(CSCD)0ARTICLEpuh3_czq@bjmu.edu.cn223862-386612
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The relationship of symptomatic thoracolumbar disc herniation and Scheuermann's disease
european spine journal, 2014Co-Authors: Liu Ning, Chen Zhongqiang, Qi Qiang, Shi ZefengAbstract:Symptomatic disc herniations in the thoracolumbar spine between T10/11 and L1/2 can be collectively called thoracolumbar disc herniation (TLDH). The etiology of this Disorder is unclear. However, it is interesting that we have noted numerous TLDH patients have radiographic features of another Spinal Disorder which is Scheuermann's disease (SD). The purpose of this study is to investigate the relationship between symptomatic TLDH and SD in a symptomatic TLDH cohort. A cohort of 63 patients with symptomatic TLDH, who had surgery was investigated. Incidences of associated SD and four radiographic signs of SD that were Schmorl's node, irregular vertebral end plate, posterior bony avulsion of the vertebra and wedge-shaped vertebra, average thoracolumbar kyphotic angle and incidences of disc herniation at segments with and without radiographic signs of SD were examined. Data from the TLDH group were compared with 57 patients undergoing surgery for lower lumbar disc herniation (LDH, L3/4-L5/S1) in the same period. The incidences of the four radiographic signs of SD and the incidence of associated SD were all significantly higher in the TLDH group than in the LDH group. 95.2 % of the patients in the TLDH group were diagnosed with SD (either classical SD or its atypical form). The average thoracolumbar kyphotic angle of the TLDH group was 16.9A degrees, while that of the LDH group was 7.6A degrees (P = 0.000). In the TLDH group, the incidences of disc herniation at segments with radiographic signs of SD were all significantly higher than at segments where no sign of SD was found. The high proportion of associated SD and the tendency of SD's signs to promote disc herniation in symptomatic TLDH patients suggest a close relationship between these two Disorders. Symptomatic TLDH should be seen as a truly different surgical entity, that is, a special form of SD rather than just an indicator of a failing back.Clinical NeurologyOrthopedicsSCI(E)PubMed2ARTICLEzhongqiang_chen@yahoo.com51059-10662
Zhongqiang Chen - One of the best experts on this subject based on the ideXlab platform.
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radiological signs of scheuermann disease and low back pain retrospective categorization of 188 hospital staff members with 6 year follow up
Spine, 2014Co-Authors: Ning Liu, Xinhu Guo, Zhongqiang Chen, Zhaoqing Guo, Yan Zeng, Chuiguo Sun, Zhongjun LiuAbstract:Low back pain (LBP) is a leading debilitating Disorder worldwide,1 affecting up to 84% of the general population at some point in life.2 It not only impacts patients' quality of life and financial well-being, but also the financial health of the entire health care system.3 The majority of LBP is nonspecific, with no sign of a specific Spinal Disorder or definite underlying condition such as cancer or infection, posing difficulty for its prevention and treatment.4 Potential LBP risk factors include physiological factors (female sex,5,6 obesity,2,7 and poor health8), socioeconomic factors (smoking,2,9 heavy workload,2,6,8 and low income10), and psychological factors (work dissatisfaction10 and depression11). However, the majority of these risk factors concern outside influences that are inherently difficult to assess in an individual clinical encounter. Among intrinsic factors, some are too subtle (e.g., sex) for use in the Spinal community, whereas others are too subtle (e.g., interleukin-1 gene cluster polymorphism2) for accessibility in typical clinical settings. Magnetic resonance (MR) of the spine can provide straightforward information on disc degeneration (DD). However, current evidence on the association between DD and LBP in adult populations is generally not strong and has been controversial.2,12,13 Therefore, identifying new intrinsic risk factors of LBP that are both straightforward and acquirable in daily practice is significant to LBP investigation and management. Scheuermann disease (SD) is a Spinal Disorder named after Dr. Holger Werfel Scheuermann, who, in 1921, first described a structural thoracic kyphosis mainly affecting adolescents.14 Its best-known manifestations are multiple wedged vertebrae (WV) and thoracic kyphosis known as Scheuermann kyphosis. Its classic diagnostic criterion was “3 or more consecutive wedged thoracic vertebrae,” proposed by Sorensen in 1964.15 However, SD pathological changes also include disc and endplate lesions, primarily Schmorl node (SN) and irregular vertebral endplate (IE).14,15 Therefore, the diagnosis of “atypical SD” was proposed for patients with only one or 2 WV and no notable kyphosis, but characteristic disc/endplate lesions, including SN and IE.16–20 Because atypical SD tends to affect the lumbar or thoracolumbar junction region instead of the thoracic spine, it is also called “lumbar SD.”16,17,19,20 Thus, SD represents a broader concept than Scheuermann kyphosis (classic SD) because it also includes lumbar SD (atypical SD) (Figure (Figure1;1; Table Table11). Figure 1. What makes up “Scheuermann disease”? The definition of SD is not uniform or fixed. Instead, it depends on the form being referred to and a corresponding combination of pathological changes. Classic SD (the upper surface of the cube) is ... TABLE 1. Description of 15 Reports on the Diagnostic Criteria of Atypical (Lumbar) SD Notably, both classic SD and atypical SD are associated with back pain.14,16,17,19–22 Although Scheuermann kyphosis is uncommon, SD radiological signs have been observed in 18% to 40% of the general population,23 suggesting that SD, or more precisely, “SD-like” spine, may be a variant of normal spine morphology rather than a disease. A genetic role in the cause of SD has been proposed, with a suspected autosomal dominant pattern of inheritance.20,24 The Trp3 allele, a variant of the COL9A3 gene, has been associated with SD.20 We speculated whether an SD-like spine is associated with LBP in the general population. However, previous studies on the relationship between SD and LBP have primarily focused on patients with Scheuermann kyphosis, back pain, or sciatica. Therefore, we conducted this study to investigate the relationship between SD-like spines and LBP in a local population of hospital staff members.
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the relationship of symptomatic thoracolumbar disc herniation and scheuermann s disease
European Spine Journal, 2014Co-Authors: Ning Liu, Zhongqiang Chen, Zefeng ShiAbstract:Purpose Symptomatic disc herniations in the thoracolumbar spine between T10/11 and L1/2 can be collectively called thoracolumbar disc herniation (TLDH). The etiology of this Disorder is unclear. However, it is interesting that we have noted numerous TLDH patients have radiographic features of another Spinal Disorder which is Scheuermann’s disease (SD). The purpose of this study is to investigate the relationship between symptomatic TLDH and SD in a symptomatic TLDH cohort.
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comparison between two types of scheuermann disease like people thoracolumbar disc herniation patients and healthy volunteers with radiological signs of scheuermann s disease
Chinese Medical Journal, 2014Co-Authors: Xinhu Guo, Ning Liu, Zhongqiang Chen, Zhaoqing Guo, Yan Zeng, Chuiguo SunAbstract:BACKGROUND: Scheuermann's disease (SD) is a Spinal Disorder and includes both a classic form and an atypical form. Interestingly, its existence among the general population as well as the disc disease patients is common. One of our previous studies showed that about 18% of the hospital staff members meet the SD criteria. On the other hand, another study has demonstrated that 95.2% of the symptomatic thoracolumbar disc herniation (STLDH) patients meet the SD criteria, which suggests that STLDH is very likely a special form of SD. The purpose of this study was to discriminate the factors contributing to the development of STLDH by comparing STLDH patients with the healthy SD-like hospital staff members. METHODS: This is a retrospective study including 33 STLDH patients who met the SD criteria and 30 SD-like hospital staff members. The STLDH group was chosen from a group of patients who underwent surgery after a diagnosis of STLDH (T10/11-L1/2) at our hospital between June 2007 and June 2010. SD-like hospital staff members were chosen from a database created in 2007, which contained a lumbar MR and low back pain (LBP) questionnaire of 188 hospital staff members. The demographic and radiologic characteristics were compared between groups. RESULTS: There was no statistical difference in sex, age, and height between the two groups. The STLDH patients had higher body weight, boby mass index, and thoracolumbar kyphotic angle than SD-like hospital staff members. In addition, STLDH patients had more levels of Schmorl's nodes (3.5±1.7 vs. 2.0±1.9, t = 3.364, P = 0.001) and irregular endplateson (4.0±1.9 vs. 2.7±1.9, t = 2.667, P = 0.010) compared to the SD-like hospital staff members. CONCLUSIONS: Higher body weight, higher body mass index, larger thoracolumbar kyphosis, and more Schmorl's nodes and irregular endplates on MR may be associated with the development of STLDH in "SD-like people."