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The paradoxical relationship between ligamentum flavum hypertrophy and developmental lumbar spinal stenosis

Overview of attention for article published in Scoliosis and Spinal Disorders, September 2016
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Title
The paradoxical relationship between ligamentum flavum hypertrophy and developmental lumbar spinal stenosis
Published in
Scoliosis and Spinal Disorders, September 2016
DOI 10.1186/s13013-016-0088-5
Pubmed ID
Authors

Prudence Wing Hang Cheung, Vivian Tam, Victor Yu Leong Leung, Dino Samartzis, Kenneth Man-Chee Cheung, Keith Dip-Kei Luk, Jason Pui Yin Cheung, Prudence Wing Hang Cheung, Vivian Tam, Victor Yu Leong Leung, Dino Samartzis, Kenneth Man-Chee Cheung, Keith Dip-Kei Luk, Jason Pui Yin Cheung

Abstract

Ligamentum flavum (LF) hypertrophy is a common cause of lumbar spinal stenosis and is thought to be degeneration-driven. Developmental spinal stenosis (DSS) is characterized by pre-existing narrowed spinal canals and is likely a developmental problem that occurs in childhood. In these cases, the LF may demonstrate different characteristics as compared to degeneration-driven stenosis. Thus, this study aimed to investigate the relationship between histological changes of LF and canal size. Patients who had surgical decompression for lumbar spinal stenosis were prospectively recruited and divided into three groups (critical DSS, relative DSS and non-DSS) based on previously defined anteroposterior bony spinal canal diameter measurements on MRI. The degree of disc degeneration and LF thickness were also measured from L1 to S1. Surgical LF specimens were retrieved for histological assessment of fibrotic grade and area of fibrosis. A total of 19 females and 15 males (110 LF specimens) with an overall mean age of 65.9 years (SD ± 9.8 years) were recruited. DSS was found to have a significant negative correlation (p < 0.001) with LF thickness, its fibrotic grade and area of fibrosis (%). Non-DSS exhibited a significant positive relationship with the degree of LF fibrosis. Disc degeneration and LF thickness had no correlation with LF histology. Our study is the first to definitively note that degeneration is the cause of LF fibrosis in non-DSS patients; however, in contrast, an inverse relationship exists between canal size and LF fibrosis in DSS patients, suggesting a different pathomechanism. Hence, despite a similar degree of LF thickness, DSS patients have LF with less fibrosis compared with non-DSS patients. Further investigation of the cause of LF changes in DSS is necessary to understand this relationship.

Twitter Demographics

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Mendeley readers

The data shown below were compiled from readership statistics for 33 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Egypt 1 3%
Unknown 32 97%

Demographic breakdown

Readers by professional status Count As %
Researcher 4 12%
Student > Postgraduate 4 12%
Professor > Associate Professor 4 12%
Lecturer 3 9%
Student > Ph. D. Student 3 9%
Other 6 18%
Unknown 9 27%
Readers by discipline Count As %
Medicine and Dentistry 17 52%
Agricultural and Biological Sciences 2 6%
Neuroscience 2 6%
Immunology and Microbiology 1 3%
Biochemistry, Genetics and Molecular Biology 1 3%
Other 2 6%
Unknown 8 24%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 24 February 2017.
All research outputs
#8,486,202
of 9,727,301 outputs
Outputs from Scoliosis and Spinal Disorders
#32
of 32 outputs
Outputs of similar age
#218,046
of 257,165 outputs
Outputs of similar age from Scoliosis and Spinal Disorders
#5
of 5 outputs
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