Abstract
Insufficient blood supply to the intervertebral disc (IVD) has been proposed to play a role as causative factor in IVD degeneration. There is an association between IVD diseases and increased risk of dying of ischaemic heart disease. Obesity and tobacco are potential risk factors for degenerative IVD disease. High blood cholesterol and triglycerides serum levels are risk factors for atherosclerosis, and could be responsible for a decreased in the blood supply to the already poor vascularized IVD. We performed a frequency-matched case–control study to determine the serum levels of patients with symptomatic herniated lumbar disc. We examined the fasting serum lipid levels in 384 subjects who were operated at our institution. Group 1 included 169 consecutive patients (115 men and 54 women; mean age: 59.1 years, range 29–85) who underwent surgery for symptomatic disc herniation. Group 2 (control group) included 169 patients (115 men and 54 women; mean age: 61 years, range 26–86) who underwent arthroscopic meniscectomy for a meniscal tear in the same period. These patients were frequency-matched by age (within 3 years) and gender with patients of Group 1. Sera were extracted from blood samples and the concentrations of total cholesterol (TC) and triglycerides (TG) were determined. When comparing the two groups, patients with symptomatic herniated lumbar disc showed statistically significant higher triglyceride concentration (P = 0.02) and total cholesterol concentration (P = 0.01). Serum lipid levels may be a risk factor for IVD pathology. An enhanced understanding of these factors holds the promise of new approaches to the prevention and management of IVD pathology.
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References
Andreoli M (2000) Manuale medico di endocrinologia a metabolismo. Il pensiero scientifico:691–718
Austin MA, Hokanson JE, Edwards KL (1998) Hypertriglyceridemia as a cardiovascular risk factor. Am J Cardiol 81:7–12
Bassuk SS, Manson JE (2003) Physical activity and the prevention of cardiovascular disease. Curr Atheroscler Rep 5:299–307
Battie MC, Videman T, Gill K, Moneta GB, Nyman R, Kaprio J, Koskenvuo M (1991) 1991 Volvo Award in clinical sciences. Smoking and lumbar intervertebral disc degeneration: an MRI study of identical twins. Spine 16:1015–1021
Boudriot U, Schmitt J, Pfeiffer M (2005) Thoracic herniation after lumbar spine fusion. Arch Orthop Trauma Surg 125:493–498
Denaro L, Longo UG, Denaro V (2009) Vertebroplasty and kyphoplasty: reasons for concern? Orthop Clin North Am 40:465–471 viii
Denaro L, Longo UG, Papalia R, Di Martino A, Maffulli N, Denaro V (2008) Eosinophilic granuloma of the paediatric cervical spine. Spine (Phila Pa 1976) 33:E936–E941
Denaro V, Longo UG, Denaro L (2010) Vertebroplasty versus conservative treatment for vertebral fractures. Lancet 376:2071 author reply 2071–2072
Echarri JJ, Forriol F (2005) Influence of the type of load on the cervical spine: a study on Congolese bearers. Spine J 5:291–296
Frymoyer JW (1988) Back pain and sciatica. N Engl J Med 318:291–300
Gaida JE, Ashe MC, Bass SL, Cook JL. Is adiposity an under-recognised risk factor for tendinopathy? A systematic review. Arthr Care Res (In press)
Genevay S, Finckh A, Payer M, Mezin F, Tessitore E, Gabay C, Guerne PA (2008) Elevated levels of tumour necrosis factor-alpha in periradicular fat tissue in patients with radiculopathy from herniated disc. Spine 33:2041–2046
Gilbertson L, Ahn SH, Teng PN, Studer RK, Niyibizi C, Kang JD (2008) The effects of recombinant human bone morphogenetic protein-2, recombinant human bone morphogenetic protein-12, and adenoviral bone morphogenetic protein-12 on matrix synthesis in human annulus fibrosis and nucleus pulposus cells. Spine J 8:449–456
Gotto AM (1998) Triglyceride as a risk factor for coronary artery disease. Am J Cardiol 5:22Q–25Q
Hegmann KT, Moore JS (1998) Common neuromusculoskeletal disorders. In: King PM (ed) Sourcebook of occupational rehabilitation. Plenum, New York, pp 30–32
Hubert HB, Feinleib M, McNamara PM, Castelli WP (1983) Obesity as an independent risk factor for cardiovascular disease: a 26-year follow-up of participants in the Framingham Heart Study. Circulation 67:968–977
Kauppila LI, Mikkonen R, Mankinen P, Pelto-Vasenius K, Maenpaa I (2004) MR aortography and serum cholesterol levels in patients with long-term nonspecific lower back pain. Spine 29:2147–2152
Kim KS, Owen WL, Williams D, Adams-Campbell LL (2000) A comparison between BMI and conicity index on predicting coronary heart disease: the Framingham Heart Study. Ann Epidemiol 10:424–431
Larson JW 3rd, Levicoff EA, Gilbertson LG, Kang JD (2006) Biologic modification of animal models of intervertebral disc degeneration. J Bone Joint Surg Am 88(Suppl 2):83–87
Leino-Arjas P, Kaila-Kangas L, Solovieva S, Riihima H, Kirjonen J, Reunanen A (2006) Serum lipids and low back pain-an association? A prospective study of a normal working population sample. Spine 31:1032–1037
Leino-Arjas P, Kauppila L, Kaila-Kangas L, Shiri R, Heistaro S, Heliovaara M (2008) Serum lipids in relation to sciatica among Finns. Atherosclerosis 197:43–49
Longo UG, Denaro V (2009) Spinal augmentation: what have we learnt? Lancet 373:1947 author reply 1947–1948
Longo UG, Franceschi F, Ruzzini L, Spiezia F, Maffulli N, Denaro V (2009) Higher fasting plasma glucose levels within the normoglycaemic range and rotator cuff tears. Br J Sports Med 43:284–287
Longo UG, Franceschi F, Spiezia F, Forriol F, Maffulli N, Denaro V (2010) Triglycerides and total serum cholesterol in rotator cuff tears: do they matter? Br J Sports Med 44:948–951
Longo UG, Loppini M, Denaro L, Maffulli N, Denaro V (2010) Rating scales for low back pain. Br Med Bull 94:81–144
Longo UG, Papapietro N, Maffulli N, Denaro V (2009) Thoracoscopy for minimally invasive thoracic spine surgery. Orthop Clin North Am 40:459–464 vii
Longo UG, Ripalda P, Denaro V, Forriol F (2006) Morphologic comparison of cervical, thoracic, lumbar intervertebral discs of cynomolgus monkey (Macaca fascicularis). Eur Spine J 15:1845–1851
Maiuri F, Iaconetta G, Gambardella A (2000) Ossification of the yellow ligament causing thoracic cord compression. Arch Orthop Trauma Surg 120:346–348
Maiuri F, Iaconetta G, Gambardella A, Buonamassa S (2000) Cervical spine stenosis due to ossification of the posterior longitudinal ligament in Italian patients: surgical treatment and outcome. Arch Orthop Trauma Surg 120:441–444
Mitchell JRA, Adams JH (1977) Aortic size and aortic calcification: a necropsy study. Atherosclerosis 27:437–446
Penttinen J (1994) Back pain and risk of fatal ischaemic heart disease: 13 year follow up of Finnish farmers. Bmj 309:1267–1268
Post RB, Leferink VJ (2004) Spinal mobility: sagittal range of motion measured with the SpinalMouse, a new non-invasive device. Arch Orthop Trauma Surg 124:187–192
Ratcliffe JF (1982) The anatomy of the fourth and fifth lumbar arteries in humans: an arteriographic study in one hundred live subjects. J Anat 135:753–761
Risbud MV, Guttapalli A, Tsai TT, Lee JY, Danielson KG, Vaccaro AR, Albert TJ, Gazit Z, Gazit D, Shapiro IM (2007) Evidence for skeletal progenitor cells in the degenerate human intervertebral disc. Spine 32:2537–2544
Roughley PJ (2004) Biology of intervertebral disc aging and degeneration: involvement of the extracellular matrix. Spine 29:2691–2699
Schaefer EJ, Asztalos BF (2006) The effects of statins on high-density lipoproteins. Curr Atheroscler Rep 8:41–49
Scuderi GJ, Brusovanik GV, Anderson DG, Dunham CJ, Vaccaro AR, Demeo RF, Hallab N (2006) Cytokine assay of the epidural space lavage in patients with lumbar intervertebral disk herniation and radiculopathy. J Spinal Disord Tech 19:266–269
Siervogel RM, Wisemandle W, Maynard LM, Guo SS, Chumlea WC, Towne B (2000) Lifetime overweight status in relation to serial changes in body composition and risk factors for cardiovascular disease: The Fels Longitudinal Study. Obes Res 8:422–430
Stairmand JW, Holm S, Urban JP (1991) Factors influencing oxygen concentration gradients in the intervertebral disc: a theoretical analysis. Spine 16:444–449
Steinberg D (2002) Atherogenesis in perspective: hypercholesterolemia and inflammation as partners in crime. Nat Med 8:1211–1217
Svensson HO, Vedin A, Wilhelmsson C, Andersson GB (1983) Low-back pain in relation to other diseases and cardiovascular risk factors. Spine 8:277–285
Urban JPG, Roberts S (2003) Degeneration of the intervertebral disc. Arthritis Res Ther 5:120–130
Vaccaro AR, Fehlings MG (2007) The applicability of clinical equipoise and sham surgery in patients with symptomatic lumbar radiculopathy due to a herniated disc: the SPORT trial. Spine 32:2039–2040
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All procedures described in this study were approved by the Ethics Committee of our Institution. All patients provided written informed consent.
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Longo, U.G., Denaro, L., Spiezia, F. et al. Symptomatic disc herniation and serum lipid levels. Eur Spine J 20, 1658–1662 (2011). https://doi.org/10.1007/s00586-011-1737-2
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DOI: https://doi.org/10.1007/s00586-011-1737-2