Spine Phenotypes

1st Edition - July 8, 2022

Editors: Dino Samartzis, Jaro I. Karppinen, Frances M.K. Williams

Hardback ISBN:

9 7 8 - 0 - 1 2 - 8 2 2 7 7 8 - 7

eBook ISBN:

9 7 8 - 0 - 1 2 - 8 2 2 7 7 9 - 4

The era of big data and personalized spine care has arrived. Within that, imaging and clinical phenotypes are key in establishing personalized algorithms for patient care. This is… Read more

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The era of big data and personalized spine care has arrived. Within that, imaging and clinical phenotypes are key in establishing personalized algorithms for patient care. This is particularly important in developing novel diagnostics and therapeutics as well as predicting outcomes and establishing preventative measures for various spinal disorders. Spine Phenotypes is a comprehensive resource that outlines phenotype descriptions, their imaging measurements and classifications, and provides an in-depth discussion regarding spine pathology and its clinical relevance.

Multiauthored, with multidisciplinary contributions from world leaders in the field of imaging, spine research, and clinical practice, each chapter is rich in visual depiction of imaging phenotypes, providing examples of some established phenotypic measurements with a range of normal and pathologic images and their clinical implications.

Spine Phenotypes

will be a first of its kind reference for spine researchers, clinicians, and industry.

Cover image
Title page
Table of Contents
Copyright
Contributors
Foreword
Foreword by Jeremy Fairbank MD FRCS, Professor of Spine Surgery and Honorary Departmental Senior Research Fellow, NDORMS, University of Oxford, UK
Preface
Acknowledgments
Acknowledgment
1. Anatomy of the spine
Introduction
Osseous spine
Joints, discs, and ligaments
Muscles and fasciae
Neurovasculature
Conclusions
2. Biomechanics of the spine
Introduction
The spinal anatomy in vertebrates and humans
The intervertebral disc
Zygapophyseal/facet joints
Spinal ligaments
Biomechanics of degeneration-related phenotypes in the human lumbar spine
3. Biomechanical models to study spinal phenotypes
Introduction
Intervertebral disc degeneration phenotypes
Intervertebral injury models
Broader context and implications for repair
Conclusion
4. Animal models to study spinal intervertebral disc phenotypes
Introduction
Anatomy
Conclusions
5. Imaging technologies of the spinal discs
Introduction
Computed tomography
MRI methods to investigate morphology
Conclusion
6. Intervertebral disc degeneration
Degeneration and low back pain
Etiological factors of intervertebral disc degeneration
Methods for assessing the phenotypes of disc degeneration
Classification schemes of disc degeneration
Conclusions
7. Disc space narrowing and osteophytes
Introduction
Pathogenesis
Radiological features
Epidemiology
Osteophyte epidemiology
IVD narrowing epidemiology
Association with facet joint arthropathy
Influence of osteophytes and IVD space narrowing on low back pain
Complications/sequela of osteophytosis and IVD space narrowing
High-intensity zones
IVD calcification
Clinical management
Diffuse idiopathic skeletal hyperostosis
Conclusions
8. Displacement of intervertebral discs
Introduction
Anatomy
Pathogenesis
Imaging
Morphologic phenotypes of IVD displacement
Clinical phenotypes of disc displacement—evaluation and treatment
Conclusions
9. High-intensity zones and annular tears
Background
Pathology of HIZs
Biomechanics of HIZs
Epidemiology
Clinical implications of HIZ
Risk factor for HIZ
Phenotype
Association with other MRI phenotypes
Conclusions
10. Vertebral endplate abnormalities, defects, and changes
The vertebral endplate during development
Structure and composition of the endplate
Endplate function
Endplate and back pain
Endplate classification schemes
Conclusions
11. Vertebral bone marrow (Modic) changes
Introduction
Pathogenesis
Manifestations and natural history
Clinical presentation
Imaging and diagnostic studies
Management
Conclusions
12. Ossification of the posterior longitudinal ligament
Introduction
Epidemiology
Etiology and pathogenesis
Clinical manifestations
Management
Conclusions
13. Lumbar spinal stenosis
Introduction
Pathogenesis
Manifestations and natural history
Clinical phenotypes
Imaging phenotypes
Management
Conclusions
14. Facet joints
Introduction
Facet joint degeneration
Grading of facet joint degeneration
Conclusion
15. Paraspinal muscles
Introduction
Anatomy and function
Assessments on medical images
Factors affecting muscle morphometry other than low back pain
Relations between muscle morphometry and other spinal degeneration
Relationship between paraspinal muscle morphometry and LBP/LBP-related disability
Exercises for restoring morphometry and their effects on LBP
Clinical implications from the relationship between paraspinal muscles and LBP
Future research
16. Spinal alignment
Introduction
History
Basic radiographic parameters—thoracic and lumbar spine
The contribution of pelvic anatomy to global alignment
Cervical alignment contribution to global spinal balance
Thoracic and lumbar contribution to global spinal balance
Regional differences in thoracolumbar balance: patterns of alignment
Clinical impact of sagittal alignment and balance
Changes in pelvic morphology with aging
Postsurgical positive sagittal balance
Spinal surgery surgical planning
Conclusions
Index

Dino Samartzis

Dr. Samartzis obtained his undergraduate degree from Northwestern University, and further pursued graduate studies in biological sciences, evidence-based health care, clinical epidemiology, medical sciences, and international studies at Harvard University, University of Oxford (UK), University of Cambridge (UK), Erasmus University (The Netherlands), Charles University (Czech Republic), and London School of Economics and Political Science (UK). He completed a postdoctoral fellowship at the The University of Hong Kong. He went on to become the Gilbert Beebe Fellow of the Radiation and Nuclear Board of the National Academies of Science in Washington D.C. and the United States Department of Energy, the Radiation Epidemiology Branch of the National Institutes of Health in Bethesda, Maryland, and at the Radiation Effects Research Foundation (a.k.a. Atomic Bomb Casualty Commission) in Hiroshima, Japan. He has published over 350 peer-reviewed studies in high-impact journals (e.g., Lancet, Arthritis & Rheumatism, JBJS, etc.), book chapters and web-based articles.

Affiliations and expertise

Director, International Spine Research and Innovation Initiative (ISRII), Associate Professor, Department of Orthopedic Surgery, Rush Medical College, Chicago, Illinois

Jaro I. Karppinen

Jaro Karppinen is Professor of Physical and Rehabilitation Medicine at the Institute of Clinical Medicine, University of Oulu, in Northern Finland. He also works at the Finnish Institute of Occupational Health as a specialist of Physical and Rehabilitation Medicine. He has an academic degree in Biochemistry and has been an investigator in many clinical studies related to low back pain and sciatica. His current research interest has focused on environmental and genetic risk factors of degenerative spinal disorders with a special focus on the etiology and diagnostics of Modic changes. He is the Project Leader of the musculoskeletal subprojects of the Northern Finland Birth Cohorts and a Member of the Executive Group the Northern Finland Birth Cohorts. He is a member of the International Society for the Study of the Lumbar Spine, International Association for the Study of Pain, European Spine Society, and AOSpine Research Network.

Affiliations and expertise

Center for Life Course Health Research, University of Oulu, Oulu, Finland

Frances M.K. Williams

Frances M.K. Williams is a professor at King’s College London and an honorary consultant in rheumatology at Guy’s and St. Thomas’ NHS Foundation Trust. She’s been a member of the Royal College of Physicians since 1995, completed her PhD at the University of London in 2002 and is also a Fellow at the Royal College Physicians of Edinburgh since 2007. Dr. Williams performs genetic and epidemiological studies in Twins UK and UK Biobank volunteers, as well as patients, to understand better the genetic basis for common conditions such as back pain, age-related hearing impairment and fibromyalgia. The areas of special interest are: intervertebral disc degeneration and low back pain, osteoporosis and vertebral fracture, and chronic pain syndrome. Dr. Williams was the International Society for the Study of Lumbar Spine prizewinner for clinical studies in both 2015 and 2019 and has authored 120+ articles.

Affiliations and expertise

King’s College London and Honorary Consultant in Rheumatology, Guy’s and St. Thomas’ NHS Foundation Trust