A systematic review evaluating the association of atherosclerosis and lumbar degenerative disc disease.

IF 1.9 Q3 CLINICAL NEUROLOGY Brain & spine Pub Date : 2024-09-12 eCollection Date: 2024-01-01 DOI:10.1016/j.bas.2024.103901
Wensen Li, Niek Djuric, Carmen L A Vleggeert-Lankamp
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Abstract

Introduction: Lumbar disc herniation (LDH) and disc degeneration (DD) are associated with low back pain (LBP) and sciatica, which are common health problems. Emerging evidence suggests a link between vascular health, specifically abdominal aortic calcification (AAC) and systemic lipid profiles, and these spinal conditions.

Research question: This study investigates the associations between AAC, systemic lipid profiles, lumbar Modic Changes (MC), DD/LDH, and the occurrence of LBP or sciatica.

Material and methods: A literature search was performed (up to August 2023) in PubMed, Embase, Web of Science, Emcare, Cochrane Library, and Academic Search Premier utilizing a sensitive search strategy. Studies were chosen based on predefined criteria and assessed for bias using an adapted Cochrane checklist. Specifically, studies exploring the relationship between AAC or lipid status and DD/LDH and/or LBP/Sciatica were included.

Results: Twenty-seven studies were included. Eight studies assessed the association between atherosclerosis or lipid status and clinical LBP/sciatica, with four showing a positive association between AAC/lumbar artery stenosis and these conditions. Twenty-one studies assessed atherosclerosis and DD/LDH, with seven showing a positive association between AAC and DD/LDH. Eight trials found a positive association between lipid status and DD/LDH, and two trails identified ApoL1 as a biomarker for LDH recovery.

Discussion and conclusion: Evidence supports the hypothesis that inadequate blood supply contributes to disc degeneration, inflammation and clinical symptoms. Both local vascular issues and systemic lipid profiles appear to influence lumbar degeneration, highlighting the need for further research to better understand these relationships and develop preventive and therapeutic strategies.

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评估动脉粥样硬化与腰椎间盘退行性病变关系的系统性综述。
导言腰椎间盘突出症(LDH)和椎间盘变性(DD)与腰背痛(LBP)和坐骨神经痛有关,是常见的健康问题。新的证据表明,血管健康,特别是腹主动脉钙化(AAC)和全身血脂状况,与这些脊柱疾病之间存在联系:本研究调查了腹主动脉钙化、全身血脂状况、腰椎莫迪变化(MC)、DD/LDH 与腰痛或坐骨神经痛发生之间的关联:采用灵敏的检索策略,在 PubMed、Embase、Web of Science、Emcare、Cochrane Library 和 Academic Search Premier 中进行了文献检索(截至 2023 年 8 月)。根据预先确定的标准选择研究,并使用改编的 Cochrane 核对表评估研究的偏倚性。具体而言,纳入了探讨 AAC 或血脂状况与 DD/LDH 和/或 LBP/Sciatica 之间关系的研究:结果:共纳入 27 项研究。八项研究评估了动脉粥样硬化或血脂状况与临床肢体疼痛/坐骨神经痛之间的关系,其中四项研究显示 AAC/腰动脉狭窄与这些病症呈正相关。21 项研究评估了动脉粥样硬化和 DD/LDH,其中 7 项显示 AAC 与 DD/LDH 呈正相关。八项试验发现血脂状况与 DD/LDH 呈正相关,两项试验确定载脂蛋白 L1 是 LDH 恢复的生物标志物:有证据支持血液供应不足导致椎间盘退化、炎症和临床症状的假设。局部血管问题和全身脂质状况似乎都会影响腰椎退行性变,因此需要进一步研究,以更好地了解这些关系,并制定预防和治疗策略。
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来源期刊
Brain & spine
Brain & spine Surgery
CiteScore
1.10
自引率
0.00%
发文量
0
审稿时长
71 days
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