Effects of Spinal Traction in Nutrition Supply for Severe Degenerative Disc
Date Issued
2012
Date
2012
Author(s)
Chuang, I-Ting
Abstract
Objective: To investigate the effect of spinal traction on nutrition supply of simulated severe degenerative discs using a whole disc culture system.
Summary of background data: Spinal traction is a well-recognized and safe physical therapy for patients with degenerative disc diseases before surgical remedies. Disc degradation leads to disc height loss and intervertebral foramen narrowing, which compress nerve root and thus induce low back pain and limb numbness. It was proved that traction treatment could expand the intervertebral foreman, so as to reduce radiculopathy in the short-term. Nevertheless, there was lack of knowledge on long-term benefits on nutrition supply for maintaining disc height. Hence, the purpose of this study was to investigate the effects of spinal traction treatment on disc nutrition supply and discover the efficiency of this method on disc regeneration.
Methods: Thoracic spinal segments (T4-T7) were harvested from six-month-old pigs with average weight of 140 kg in 4~6 hours after sacrifice. Each disc was dissected out by parallel cutting through the transverse midline of cranial and caudal vertebra. The muscles, ligaments, and posterior process were removed before PBS irrigation. Specimens were assigned to the Intact, Severe-degeneration, and Traction group. All discs were physiologically loaded and incubated in an in-house whole organ culturing system for one week. To mimic severe degeneration discs, discs of Severe-degeneration and Traction group were applied with trypsin solution (0.5ml, 0.25%) injection and 5-hour fatigue loading (Frms: 420N, frequency: 2.0Hz) on the first and second day of the incubation period. Discs of Traction group were then treated with spinal traction (traction force: 20kg, duration: 30mins, one cycle: 30 s traction and 10 s relaxation) once per day from the 4th to 6th day of incubation period. Molecular transportation, disc height, cell viability and histology were observed at the end of incubation period. Molecular transportation was evaluated by fluorescence intensity of fluorescein sodium (FS) within discs, which was circulated in the culture system for 1 hr. One-way ANOVA was conducted to compare all measurements. Statistical difference was considered at p<0.05.
Result: Severe degenerated discs were found to be with lower disc height, thinner endplate, anulus bulging, lower FS fluorescence intensity within disc and more dead cells in both nucleus pulposus and anulus fibrosus. In Traction group, it was shown that disc height and endplate thickness increased, AF retracted, fluorescent intensity elevated and cells relived.
Conclusion: Spinal traction is capable to recover endplate thickness and excessive AF bulging, which successfully opens the blocked nutrition pathways in severe degenerative discs. Improved nutrition supply not only maintains disc height, but also facilitates disc cell growth and thus decelerates degeneration process.
Subjects
spinal traction
disc degeneration disease
whole disc culture system
nutrition supply
Type
thesis
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