A study on the familial occurrence and genetic factors of the thickening of ligamentum flavum in lumbar spinal stenosis

2023 Fiscal Year Final Research Report

• Project/Area Number: 21K09266
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 56020:Orthopedics-related
• Research Institution: National Center for Geriatrics and Gerontology
• Principal Investigator: Matsui Hiroki 国立研究開発法人国立長寿医療研究センター, 病院, 医長 (70612802)
• Co-Investigator(Kenkyū-buntansha): 渡邉 研 国立研究開発法人国立長寿医療研究センター, 研究所 運動器疾患研究部, 部長 (10342966) ; 酒井 義人 国立研究開発法人国立長寿医療研究センター, 病院, 部長 (70378107)
• Project Period (FY): 2021-04-01 – 2024-03-31
• Keywords: 腰部脊柱管狭窄症 / 黄色靱帯

Outline of Final Research Achievements

Ligamentum flavum thickness in lumbar spinal stenosis is one of the most important etiologies; however, factors other than age-related degeneration are involved. Evaluation if the flavum in the upper lumbar spine, which is less subject to mechanical stress, allows clarification of the pathogenesis of lumbar spinal stenosis and development of preventive and therapeutic procedures. We evaluated the definition of ligamentum flavum hypertrophy at L1/2 level based on MRI cross-sectional area of the flavum, and analyzed the percentage and clinical characteristics of the flavum hypertrophy in the upper level of spinal stenosis. In addition, genome-wide association study of blood sample for the flavum hypertrophy in the upper lumbar spine demonstrated multiple loci with significant levels of genome association, and pathway analysis suggested that spinal canal area and embryological neurogenesis may be involved.

Free Research Field

腰部脊柱管狭窄症

Academic Significance and Societal Importance of the Research Achievements

腰部脊柱管狭窄症に対する保存治療は対症療法が主であり、手術治療に頼らざるを得ない部分が大いにある。病態の一つである黄色靱帯肥厚に対して形態学的な可逆的アプローチが可能となれば新たな治療法開発に寄与するであろう。機械的ストレス以外の病態生理を解明するためのゲノム関連解析と、それを可能にする臨床的分類が必要であり、本研究成果により今後の研究に対する方向性を見出すことができた。