Background Spine osteoarthritisis one of the leading places in the structure of the Rheumatic Diseases. Until recently, the degeneration of the intervertebral disc (IVD), reflected in the reduction of the number of cell and components of the matrix (proteoglycans, collagen), associated with aging. There is evidence for development of accelerated degeneration IVD, which can result in long-term microtraumatic actions to spinal motion segment (SMS). Detection of a degenerative changes IVD in adolescence and early young age using magnetic resonance imaging as well as the height frequency of low back pain in the young cohort of patients suggests a different morphological mechanisms of disease.
Objectives To study SMS morphology in spine osteoarthritis patients in different age groups.
Methods 28 spine osteoarthritis patients with LBP were examined. Diagnosis was confirmed by spondilography and MRI (including the stage of IVD degeneration, Pfirrmann CW, 2001). Pain intensity (pain Visual Analogue Score (VAS), mm) and pain duration (IASP, 1994) were assessed. All patients were operated for hernia lumbar disk. The patients were divided into 2 groups by age. Group 1 -14 patients (7 male, 7 women), mean age – 28,8 years (22 to 34). Group 2- 14 patients (6 men, 8 women), mean age – 45,6 years (35 to 55). The average age at onset disease in group 1- 27,6 (25-34) years, in group 2 – 35,5 (27-47) years. Histologycal state of IVDs and endplates, removedsurgically, were studied. Statistical analysis was performed using SPSS 15.0 for Windows
Results All patients had an acute pain with VAS 60,7 ± 2,63 mm in group 1, and VAS 69,2 ± 2,73 mm in group 2. In 92.8% younger patients were diagnosed herniated disc L5 - S1, in group 2 - hernia IVD L4 - L5 in 57. Older patiens had more intensive stain of matrix IVD, showing a high content of proteoglycans, compared with a group of younger patients (p = 0.03). Number of chondrocytes in annulus fibrosus and notochordal cells of nucleus pulposus, both single and combined into a clusters, were determined statistically significantly higher in the disks 2 group (p=0,043 and p=0,033, respectively).
Conclusions Intervertebral disc degeneration has specific mechanisms of development in different age groups of spine osteoarthritis patients. In degenerative disc elderly patients prevail reparative processes, a sign of which is a greater number of actively proliferating cells and high levels of proteoglycans intercellular substance, which is probably a response to the long-term microtraumatic actions to SMS. In younger patients, disc degeneration associated with poor synthetic activity reduced number of cellular elements in the disc, which requires further study.
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Disclosure of Interest None Declared
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