Elucidation of the mechanism of intervertebral disc degeneration and Modic changes in spinal deformity

2023 Fiscal Year Final Research Report

• Project/Area Number: 21K09311
• 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: St. Marianna University School of Medicine
• Principal Investigator: Akazawa Tsutomu 聖マリアンナ医科大学, 医学部, 教授 (90375808)
• Co-Investigator(Kenkyū-buntansha): 鈴木 崇根 千葉大学, 大学院医学研究院, 准教授 (30513072) ; 松浦 佑介 千葉大学, 医学部附属病院, 助教 (60638336)
• Project Period (FY): 2021-04-01 – 2024-03-31
• Keywords: 椎間板変性 / Modic変性 / Modic changes / 脊柱変形 / 側弯症

Outline of Final Research Achievements

In patients with spinal deformity who had a long postoperative course, the prevalence of intervertebral disc degeneration was 76.9%, and the prevalence of Modic changes was 66.7%. During the 7 years of middle age, disc degeneration progressed, and sagittal alignment worsened. Preserving no more than three mobile discs was a factor that worsened disc degeneration. Bone density and T-score in midlife for female patients with spinal deformity have significantly decreased over the past 7 years, and the larger the scoliosis of the main thoracic curve or lumbar curve, the lower the annual Z-score change. was. Structural analysis using the finite element method of deformed vertebrae showed that the pull-out strength was increased by 14% in the trajectory where the screw thread captured the outer cortical bone compared to the conventional trajectory.

Free Research Field

整形外科学

Academic Significance and Societal Importance of the Research Achievements

脊柱変形の脊椎固定術において可動椎間板を3椎間以上残しながら良好な矢状面アライメントとすれば、長期的な椎間板変性を予防することができる。脊柱変形手術のより大きな側弯変形を残さないことで、中年期以降の骨粗鬆症の予防につながる。変形脊椎において通常軌道にこだわらず、より皮質骨を捉える軌道でスクリュー刺入ができれば引き抜き強度を上げることが可能となる。これらは新たな脊柱変形矯正手技を開発できる可能性があることを示唆している。椎間板変性・Modic変性、骨強度と脊椎配列異常の関連性を解明したことで、脊柱変形患者の健康を長期的に維持する新たな矯正手術の開発へと繋げることができる。