Biomechanical implications of degenerative joint disease in the apophyseal joints of human thoracic and lumbar vertebrae

An experimental technique for quantifying load-sharing in cadaveric spines is used to test the hypothesis that degenerative changes in human apophyseal joints are directly related to high levels of compressive load-bearing by these joints. About 36 cadaveric thoraco-lumbar motion segments aged 64-92 years were subjected to a compressive load of 1.5 kN. The distribution of compressive stress was measured in the intervertebral discs using a miniature pressure transducer, and stress measurements were summed over area to give the compressive force resisted by the disc. This was subtracted from the applied 1.5 kN to indicate compressive load-bearing by the apophyseal joints. The cartilage of each apophyseal joint surface was then graded for degree of degeneration. After maceration, each joint surface was scored for degenerative joint disease (DJD) affecting the bone. Results demonstrated that the apophyseal joints resisted 5-96% (mean 45%) of the applied compressive force. A significant positive correlation was demonstrated between age and cartilage degeneration, age and DJD bone score, apophyseal joint load-bearing and bone score, and cartilage score and load-bearing. The latter correlation was strongest for load-bearing above 50%. Ordinal regression showed that the variables describing bone DJD (marginal osteophytes, pitting, bony contour change, and eburnation) were significantly correlated with degree of cartilage degeneration. It is concluded that in elderly individuals apophyseal joint load-bearing above a threshold of 50% is associated with severe degenerative changes in cartilage and bone, and that markers of DJD observed palaeopathologically may be used as predictors of such loadingin life.     

Built for speed: strain in the cartilaginous vertebral columns of sharks

In most bony fishes vertebral column strain during locomotion is almost exclusively in the intervertebral joints, and when these joints move there is the potential to store and release strain energy. Since cartilaginous fishes have poorly mineralized vertebral centra, we tested whether the vertebral bodies undergo substantial strain and thus may be sites of energy storage during locomotion. We measured axial strains of the intervertebral joints and vertebrae in vivo and ex vivo to characterize the dynamic behavior of the vertebral column. We used sonomicrometry to directly measure in vivo and in situ strains of intervertebral joints and vertebrae of Squalus acanthias swimming in a flume. For ex vivo measurements, we used a materials testing system to dynamically bend segments of vertebral column at frequencies ranging from 0.25 to 1.00 Hz and a range of physiologically relevant curvatures, which were determined using a kinematic analysis. The vertebral centra of S. acanthias undergo strain during in vivo volitional movements as well as in situ passive movements. Moreover, when isolated segments of vertebral column were tested during mechanical bending, we measured the same magnitudes of strain. These data support our hypothesis that vertebral column strain in lateral bending is not limited to the intervertebral joints. In histological sections, we found that the vertebral column of S. acanthias has an intracentral canal that is open and covered with a velum layer. An open intracentral canal may indicate that the centra are acting as tunics around some sections of a hydrostat, effectively stiffening the vertebral column. These data suggest that the entire vertebral column of sharks, both joints and centra, is mechanically engaged as a dynamic spring during locomotion.     

Arthritis in Roman Britain.

The pattern of arthritis in Roman Britain was investigated by examining the skeletons of 416 adults from the Roman cemetery at Poundbury Camp near Dorchester, Dorset. The mean height of the people was not much less than that of the current British population, and the prevalence of right handedness was similar to our own. There was a high prevalence of osteoarthritis for such a relatively young community, with particularly severe changes in the vertebral column. The pattern of joints affected by osteoarthritis was different from that seen now, but the prevalence of vertebral ankylosing hyperostosis was much the same. Rheumatoid arthritis was seen as often as the expected rat would indicate, given that the population died young, but it was rare. Other forms of arthritis, including gout and ankylosing spondylitis, were not seen.     

Importance of mechanics and kinematics in determining the stiffness contribution of the vertebral column during body-caudal-fin swimming in fishes

Whole-body stiffness in fishes has important consequences for swimming mode, speed and efficiency, but the contribution of vertebral column stiffness to whole-body stiffness is unclear. In our opinion, this lack of clarity is due in part to the lack of studies that have measured both in vitro mechanical properties of the vertebral column as well as in vivo vertebral kinematics in the same species. Some lack of clarity may also come from real variation in the mechanical role of the vertebral column across species. Previous studies, based on either mechanics or kinematics alone, suggest species-specific variation in vertebral column locomotor function that ranges from highly stiff regimes that contribute greatly to whole-body stiffness, and potentially act as a spring, to highly compliant regimes that only prohibit excessive flexion of the intervertebral joints. We review data collected in combined investigations of both mechanics and kinematics of three species, Myxine glutinosa, Acipenser transmontanus, and Morone saxatilis, to illustrate how mechanical testing within the context of the in vivo kinematics more clearly distinguishes the role of the vertebral column in each species. In addition, we identify species for which kinematic data are available, but mechanical data are lacking. We encourage further investigation of these species to fill these mechanical data gaps. Finally, we hope these future combined analyses will identify certain morphological, mechanical, or kinematic parameters that might be associated with certain vertebral column functional regimes with respect to body stiffness.     

赤峰兴隆沟遗址人类椎骨疾病的生物考古学研究

对赤峰兴隆沟遗址第一地点出土的人类椎骨上椎体的退行性关节病(DJD)和黄韧带骨化(OLF)进行了生物考古学研究,制订了这两种病症患病程度的分级记录标准,并对患病率和患病程度均值进行了统计分析。对两性的对比发现DJD的差异主要体现在男性颈椎患病较多而女性腰椎患病较多,OLF的主要差异则是男性胸椎患病率显著高于女性。通过与对比组的比较,发现兴隆沟组腰椎、颈椎DJD患病率相对较高,并再次验证了两性患病情况存在的明显差异;兴隆沟组OLF患病率与对比组也有显著差异。兴隆沟组的椎骨患病情况不一定与生业模式有关,只反映了脊柱承受负荷的情况,其差异暗示行为模式上的差异。建议开展其他方面研究以详细了解其行为模式,同时要重视建立统一的古病理研究标准的重要性。     

Paleoepidemiology of vertebral degenerative disease in a Pre-Columbian Muisca series from Colombia

Major manifestations of vertebral degenerative joint disease were observed on a Pre-Columbian Muisca series from the Soacha Cemetery (11th to 13th centuries) Colombia, South America. In total, 1,646 vertebrae of 83 individuals were examined. Osteophytes, vertebral body joint surface contour change ("lipping"), and vertebral body pitting were evaluated for each vertebral body. For apophyseal joints, joint surface contour change, pitting, and eburnation were recorded. Two methods of frequency calculation and five for vertebral degenerative disease diagnosis were applied and compared, allowing discussion of methodological considerations. Our study showed that 83% of individuals and 32% of vertebrae were classified as positive when diagnosed by the presence of at least one of the following manifestations: osteophytes, vertebral body joint surface contour change ("lipping"), apophyseal joint surface contour change, or eburnation (method called "Pitting excluded"). No significant differences were found between the sexes. In the youngest cohort (15-30 years), 65% of individuals and 10% of vertebrae exhibit at least one of the previously mentioned manifestations. High prevalences suggest a high level of physical activity beginning in childhood which may have accelerated the aging process in this Pre-Columbian population. Historical data are compatible with this hypothesis.     

Paleopathology of the Late Roman-Early Byzantine cemeteries at Sayala,Egyptian Nubia

The paleopathological pattern of three large burial complexes CI-CIII and of cemetery N (but not of cemetery A) at Sayala, Egyptian Nubia, shows a predominance of traumatism over other pathologies. Males compared with females were more often afflicted by injuries. In the skull, mostly the frontal and parietal regions, and more often the left than the right side, show traumatic changes. Cuts are most common, suggesting their origin from swords and daggers. Also traumatism of the vertebral column is high, comprising more compression fractures than post-traumatic synostoses of vertebrae, and afflicting mostly the lumbar, lower thoracic and lower cervical regions. This suggests falls in a sitting position, probably while riding camels. In the remaining postcranial skeleton, mostly fractures are present, most often afflicting the antebrachial bones, especially on the left side. The majority of the ulnar fractures are typical parry fractures. Most injuries are well healed, only some showing quick death after affliction. The overall pattern suggests fighting as the leading cause of the traumatism. Among other pathologies, osteophytosis, especially in males, occurs rather commonly and more intensively than with the comparative sample of the C-Group people. Evidence of inflammations and tumours is rare. Some senile changes, many congenital anomalies, occasional orthopaedic deviations, and affections of unknown origin complement the paleopathological picture. Some functional changes disclose overloading of both extremities. According to these findings, the way of life and the question of ethnic identification of the people are discussed.     

Pathology and the posture of the La Chapelle-aux-Saints Neandertal

The depiction of the Neandertals as incompletely erect was based primarily on Boule's (1911, 1912a, 1913) analysis of the La Chapelle-aux-Saints 1 partial skeleton. The inaccurate aspects of Boule's postural reconstruction were corrected during the 1950s. However, it has come to be believed, following Straus and Cave (1957), that Boule's errors of reconstruction were due to the diseased condition of the La Chapelle-aux-Saints 1 remains, rather than to Boule's misinterpretation of morphology. The abnormalities on the La Chapelle-aux-Saints 1 postcranium include: lower cervical, upper thoracic, and lower thoracic intervertebral degenerative joint disease (DJD), a distal fracture of a mid-thoracic rib, extensive DJD of the left hip, DJD of the right fifth proximal interphalangeal articulation, bilateral humeral head eburnation, and minor exostosis formation on the right humerus, ulna, and radius. These were associated with extensive alveolar inflammation including apical abscesses and antemortem tooth loss, some temporomandibular DJD, bilateral auditory exostoses, and minimal occipital condyle DJD. None of these abnormalities significantly affected Boule's Neandertal postural reconstruction, and a review of his analysis indicates that early twentieth century interpretations of skeletal morphology (primarily of the cranium, cervical vertebrae, lumbar and sacral vertebrae, proximal femora and tibiae, posterior tarsals, and hallucial tarsometatarsal joint), combined with Boule's evolutionary preconceptions, were responsible for his mistaken view of Neandertal posture.     

Computed tomography in the diagnosis of degenerative diseases of the spine

CT and roentgenography were used for the investigation of 78 patients with the radicular syndrome. The state of the intervertebral disks, intervertebral joints and cerebrospinal canal in degenerative vertebral diseases was assessed. CT permits the detection of hernia, protrusion of the intervertebral disks, deformity of the intervertebral joints, and the narrowing of the cerebrospinal canal as a result of degenerative changes, as well as establishing the cause of the affection of neural structures in the cerebrospinal canal, radicular holes. CT possesses some advantages over roentgenography in the diagnosis of degenerative vertebral diseases and can be recommended as the principal method together with roentgenography for investigation of patients with lumbar pains.     

Paleopathology of the commoners at Tell Amarna, Egypt, Akhenaten's capital city

The Egyptian Pharaoh Akhenaten initiated worship of a single god and established a new capital city (Tell Amarna) that was built and occupied only once from 1350-1330 BCE. This single short occupation offers a unique opportunity to study a short time period. The royal tombs have long been known and studied, but the location of graves for the common inhabitants has been an archaeological puzzle for more than 50 years. Recently four cemeteries have been located and the analysis of commingled bones from the South Tombs cemetery is presented here. The remains yield the following demographic profile: 53 adults with 19 females and 18 males; 14 juveniles between the ages of 5 and 17; and 3 infants. Arthritis and degenerative joint disease of the spine and joints indicates that DJD was not excessive. Only 2 to 8% of the adult population exhibits arthritis. There are 3 healed fractures of the arm (2 to 8% of the adult sample). There is 1 healed compressed fracture of the skull suggesting violence. The adult infection rate is between 2 and 8% with 3 healed and 1 active case of periostitis and no severe infections. Anemia is implicated by 23% of adult frontals exhibiting cribra orbitalia. Life for the common residents of Amarna appears to not have been as good as initially postulated.     

Topography and distribution of nerve fibers in the posterior longitudinal ligament of the rat: an immunocytochemical and electron-microscopical study

The distribution and immunocytochemical characterization of nerve fibers and their terminals in the posterior longitudinal ligament of the rat lumbar vertebral column was studied in whole-mount preparations and serial semithin and ultrathin sections. Differences in the localization, distribution pattern and density of peptidergic and catecholaminergic nerve fibers were found in the vertebral and intervertebral regions of the posterior longitudinal ligament. For immunocytochemistry, free floating specimens were incubated with primary antibodies against protein gene product 9.5, substance P, calcitonin gene-related peptide, dopamine-beta-hydroxylase, vasoactive intestinal polypeptide and neuropeptide Y together with the avidin-biotin-peroxidase method. In whole-mount preparations, the neural marker protein gene product 9.5 is immunostained in all unmyelinated nerve fibers in the posterior longitudinal ligament, thus giving a panoramic view of the nerve fiber plexus. The most striking nerve fiber plexus is localized in the intervertebral region. In this region, the posterior longitudinal ligament is rich in capillaries that form a dense plexus within its ventral part and extend to the outer layer of the annulus fibrosus. The peptidergic and catecholaminergic innervation of the posterior longitudinal ligament is discussed in the context of pain syndromes related to the vertebral column and degenerative lumbar spine diseases.     

Aging in the musculoskeletal system of rhesus monkeys: II. Degenerative joint disease

In order to discuss the rate and onset of adult aging in rhesus monkeys, 55 adult animals from the Wisconsin Regional Primate Research Center and the University of Wisconsin Psychology Primate Laboratory were examined. Degenerative joint disease (DJD) at the hip and spine was scored, and loss of passive joint mobility at the hip was measured. Development of DJD at both the hip and spine was significantly and positively correlated with age. Spinal changes, especially at the thoraco/lumbar intervertebral symphyses, appeared to develop somewhat more rapidly than hip degeneration. In some individuals, DJD was observed soon after the completion of growth, but pronounced changes seldom occurred before the middle of the second decade of life. Similarly, age-dependent losses of passive joint mobility appeared to begin early in ontogeny and to become increasingly pronounced in the aging adult. Although interspecific comparisons are difficult due to intraspecies and intraindividual variation, the timing of musculoskeletal aging in the rhesus spine and hip differs from that observed in humans in a way that parallels previously documented species differences in patterns of musculoskeletal growth. These observations and data on age-related change in other systems, suggest that rates and durations of many ontogenetic processes in rhesus monkeys are approximately three times as fast and one-third as long as those of the corresponding human processes. Importantly, differences in the timing of reproduction do not appear to follow the same scaling factor observed in other systems. Although reproduction may, therefore, be under separate control, the consistent pattern observed in other aspects of somatic growth and aging supports the hypothesis (Cutler, 1976; Sacher, 1978) that evolutionary changes in ontogeny have resulted from selection acting upon a few genes with widespread regulatory effects.     

The elongation of the human cervical vertebral column

Cervical vertebral elongation has been studied using serial cephalometric radiographs of 32 children examined regularly from 0.25 to 17 years. Mean vertebral body heights increased rapidly to about 2.5 years and then decelerated except for a spurt at about the age of peak height velocity. There were only small sex differences in vertebral body elongation to 12 years. From then to 15 years, the vertebral body heights in the girls exceeded those in the boys; later this sex difference was reversed. There was no pubertal spurt in disc elongation. The correlation coefficients were negative between vertebral body heights and the heights of adjoining intervertebral discs, e.g., body C3 and disc C3–4, but those between body heights or between disc heights were positive. The heights of adjacent cervical vertebral bodies were correlated more highly than the heights of non-adjacent bodies. There was a similar pattern of differences between correlation coefficients for the heights of adjacent and non-adjacent intervertebral discs.     

Diurnal fluid expression and activity of intervertebral disc cells

The intervertebral discs are large cartilaginous structures situated between the vertebral bodies, occupying around one third of the length of the spinal column. They act as the joints of the spine and carry mechanical load arising from body weight and muscle activity. Loads change with every alteration of posture and activity and the discs thus undergo a diurnal loading pattern with high loads on the discs during the day's activity and low loads on it at night during rest. As the disc is an osmotic system, around 25% of the disc's fluid is expressed and re-imbibed during each diurnal cycle with consequent changes in the osmotic environment of the disc cells. Here, present information on the effect of osmotic changes in disc cell metabolism is reviewed; results indicate that prevailing osmolarity is a powerful regulator of disc cell activity.     

新疆哈密黑沟梁墓地出土人骨的创伤、病理及异常形态研究

本文是对出土于新疆哈密黑沟梁墓地古代人骨的病理、创伤及异常形态的综合研究。通过检查,笔者发现齿科疾病、关节疾病、创伤等病理现象在该人群中都有一定频率的出现。在对这些现象进行客观描述的基础上, 本文对这些病理现象出现的原因以及反映出该批人群的生活状况做出推论。文中同时对骨骼形态与功能的关系做了尝试性分析和讨论。     

undulated, a mutation affecting the development of the mouse skeleton, has a point mutation in the paired box of Pax 1

undulated (un) homozygous mice exhibit vertebral malformations along the entire rostro-caudal axis. Pax 1, a murine paired box-containing gene, is expressed in ventral sclerotome cells and later in intervertebral disks along the entire vertebral column. We localized the Pax 1 gene on chromosome 2 between beta 2-microglobulin and the agouti locus to an area where un maps. DNA analysis of the un mutant revealed a point mutation in a highly conserved part of the paired box of Pax 1, leading to a Gly-Ser replacement. The chromosomal location and the mutation in the paired box of un mice in conjunction with Pax 1 gene expression in wild-type mice implicate a causative role of Pax 1 in generation of the vertebral column.     

Spine biomechanics

Current trends in spine research are reviewed in order to suggest future opportunities for biomechanics. Recent studies show that psychosocial factors influence back pain behaviour but are not important causes of pain itself. Severe back pain most often arises from intervertebral discs, apophyseal joints and sacroiliac joints, and physical disruption of these structures is strongly but variably linked to pain. Typical forms of structural disruption can be reproduced by severe mechanical loading in-vitro, with genetic and age-related weakening sometimes leading to injury under moderate loading. Biomechanics can be used to quantify spinal loading and movements, to analyse load distributions and injury mechanisms, and to develop therapeutic interventions. The authors suggest that techniques for quantifying spinal loading should be capable of measurement "in the field" so that they can be used in epidemiological surveys and ergonomic interventions. Great accuracy is not required for this task, because injury risk depends on tissue weakness as much as peak loading. Biomechanical tissue testing and finite-element modelling should complement each other, with experiments establishing proof of concept, and models supplying detail and optimising designs. Suggested priority areas for future research include: understanding interactions between intervertebral discs and adjacent vertebrae; developing prosthetic and tissue-engineered discs; and quantifying spinal function during rehabilitation. "Mechanobiology" has perhaps the greatest future potential, because spinal degeneration and healing are both mediated by the activity of cells which are acutely sensitive to their local mechanical environment. Precise characterisation and manipulation of this environment will be a major challenge for spine biomechanics.     

Relationship of orthopedic examination,goniometric measurements,and radiographic signs of degenerative joint disease in cats

Background  

Available information suggests a mismatch between radiographic and orthopedic examination findings in cats with DJD. However, the extent of the discrepancy between clinical and radiographic signs of OA in companion animals has not been described in detail. This study aimed to evaluate the relationship between orthopedic examination findings, joint goniometry, and radiographic signs of DJD in 100 cats, in a prospective observational design. Cat temperament, pain response to palpation, joint crepitus, effusion and thickening were graded. Radiographs of appendicular joints and the axial skeleton were made under sedation. Joint motion was measured by use of a plastic goniometer before and after sedation. Associations between radiographic degenerative joint disease (DJD) and examination findings were assessed to determine sensitivity, specificity and likelihood estimations.     

Sex differences in activity-related osseous change in the spine and the gendered division of labor at Ensay and Wharram Percy, UK

Sex differences in the distribution of vertebral degenerative and plastic change were examined and compared within and between samples of 51 individuals from the historically and ethnographically documented 16th-19th century site of Ensay, the Outer Hebrides, and 59 individuals from the medieval site of Wharram Percy, the Yorkshire Wolds. Both populations have a known gendered division of labor between males and females and known activity-related stresses on the spine. Osseous changes normally associated with degenerative joint disease (osteoarthritis) of the apophyseal facets and osteophytosis of the vertebral bodies were scored and reported separately. Inter- and intrasite differences were found in the frequency and distribution of osseous change down the spine. Overall, the Ensay sample was more highly stressed than that from Wharram Percy. Furthermore, differences between males and females at Ensay could be identified as relating to different types of activities. Distinctions between males and females at Wharram Percy were less marked, suggesting broadly similar lifestyles. These results accorded with expectations regarding contrasting levels of activity-related stress at the two sites and the division of labor between males and females. In particular, the prevalence and distribution of facet remodeling, facet sclerosis/eburnation, and osteophytosis in Ensay females could be related to load-bearing using creels (a form of basket), which disrupted "normal" patterns of osseous change along the spine. Importantly, morphologically distinct osseous modifications recorded on the apophyseal facets produced dissimilar distributions, suggesting that they may have different etiologies. These results highlight the need for a high degree of discrimination in recording, analyzing, and exploring activity-related osseous change.