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31.01.2017 | Original Article

ISSLS PRIZE IN BASIC SCIENCE 2017: Intervertebral disc/bone marrow cross-talk with Modic changes

verfasst von: Stefan Dudli, David C. Sing, Serena S. Hu, Sigurd H. Berven, Shane Burch, Vedat Deviren, Ivan Cheng, Bobby K. B. Tay, Todd F. Alamin, Ma Agnes Martinez Ith, Eric M. Pietras, Jeffrey C. Lotz

Erschienen in: European Spine Journal | Ausgabe 5/2017

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Abstract

Study design

Cross-sectional cohort analysis of patients with Modic Changes (MC).

Objective

Our goal was to characterize the molecular and cellular features of MC bone marrow and adjacent discs. We hypothesized that MC associate with biologic cross-talk between discs and bone marrow, the presence of which may have both diagnostic and therapeutic implications.

Background data

MC are vertebral bone marrow lesions that can be a diagnostic indicator for discogenic low back pain. Yet, the pathobiology of MC is largely unknown.

Methods

Patients with Modic type 1 or 2 changes (MC1, MC2) undergoing at least 2-level lumbar interbody fusion with one surgical level having MC and one without MC (control level). Two discs (MC, control) and two bone marrow aspirates (MC, control) were collected per patient. Marrow cellularity was analyzed using flow cytometry. Myelopoietic differentiation potential of bone marrow cells was quantified to gauge marrow function, as was the relative gene expression profiles of the marrow and disc cells. Disc/bone marrow cross-talk was assessed by comparing MC disc/bone marrow features relative to unaffected levels.

Results

Thirteen MC1 and eleven MC2 patients were included. We observed pro-osteoclastic changes in MC2 discs, an inflammatory dysmyelopoiesis with fibrogenic changes in MC1 and MC2 marrow, and up-regulation of neurotrophic receptors in MC1 and MC2 bone marrow and discs.

Conclusion

Our data reveal a fibrogenic and pro-inflammatory cross-talk between MC bone marrow and adjacent discs. This provides insight into the pain generator at MC levels and informs novel therapeutic targets for treatment of MC-associated LBP.

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Titel: ISSLS PRIZE IN BASIC SCIENCE 2017: Intervertebral disc/bone marrow cross-talk with Modic changes
verfasst von: Stefan Dudli
David C. Sing
Serena S. Hu
Sigurd H. Berven
Shane Burch
Vedat Deviren
Ivan Cheng
Bobby K. B. Tay
Todd F. Alamin
Ma Agnes Martinez Ith
Eric M. Pietras
Jeffrey C. Lotz
Publikationsdatum: 31.01.2017
Verlag: Springer Berlin Heidelberg
Erschienen in: European Spine Journal / Ausgabe 5/2017
Print ISSN: 0940-6719
Elektronische ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-017-4955-4

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ISSLS PRIZE IN BASIC SCIENCE 2017: Intervertebral disc/bone marrow cross-talk with Modic changes

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Objective

Background data

Methods

Results

Conclusion

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