Evidence map›Paper›PMID 25893331›Full record

ReviewEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2016

Disc herniations in astronauts: What causes them, and what does it tell us about herniation on earth?

Daniel L Belavy, Michael Adams, Helena Brisby, Barbara Cagnie, Lieven Danneels, Jeremy Fairbank, Alan R Hargens, Stefan Judex, Richard A Scheuring, Roope Sovelius and 3 more

Open access · hybridAbstract readReview
PubMed Publisher
In one paragraph

Review in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 50 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
50citing papers in PubMed, 1 pooled it
8.4field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

50 citing papers in PubMed, 1 synthesis or guideline pooled it, 105 citations in OpenAlex.

  1. Lumbar disc herniation modelling: a review of ex-vivo mechanical models and a comparison with clinical data.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2025
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  18. Effects of a microgravity SkinSuit on lumbar geometry and kinematics.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2023
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 12 institutions in 8 countries.

Daniel L BelavyCenter of Muscle and Bone Research, Charité University Medicine Berlin, Hindenburgdamm 30, 12203, Berlin, Germany. belavy@gmail.com.ORCID http://orcid.org/0000-0002-9307-832X
Michael AdamsCentre for Comparative and Clinical Anatomy, University of Bristol, Southwell Street, Bristol, BS2 8EJ, UK.
Helena BrisbyDepartment of Orthopedics, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, Gothenborg, Sweden.
Barbara CagnieDepartment of Rehabiliation Sciences and Physiotherapy, Ghent University, De Pintelaan 185 3B3, 9000, Ghent, Belgium.
Lieven DanneelsDepartment of Rehabiliation Sciences and Physiotherapy, Ghent University, De Pintelaan 185 3B3, 9000, Ghent, Belgium.
Jeremy FairbankNuffield Orthopaedic Centre, Headington, Oxford University Hospitals NHS Trust, Oxford, OX3 7HE, UK.
Alan R HargensDepartment of Orthopaedic Surgery, University of California, San Diego, San Diego, CA, 92103-8894, USA.
Stefan JudexBioengineering Building, Stony Brook University, Stony Brook, NY, 11794-5281, USA.
Richard A ScheuringJohnson Space Center, 2101 NASA Parkway SD4, Houston, TX, 77058, USA.
Roope SoveliusCentre for Military Medicine, Satakunta Air Command, PO.Box 1000, 33961, Pirkkala, Finland.
Jill UrbanDepartment of Physiology, Anatomy and Genetics, Oxford University, Le Gros Clark Building, South Parks Road, Oxford, OX1 3QX, UK.
Jaap H van DieënFaculty of Human Movement Sciences, MOVE Research Institute Amsterdam, VU University Amsterdam, van der Boechorststraat 9, Amsterdam, 1081 BT, The Netherlands.
Hans-Joachim WilkeInstitute of Orthopaedic Research and Biomechanics, University of Ulm, Helmholtzstrasse 14, 89081, Ulm, Germany.
Ghent University · BEDeakin University · AUFinnish Defence Forces · FIJohnson Space Center · USNuffield Orthopaedic Centre · GBSahlgrenska University Hospital · SEStony Brook University · USUniversität Ulm · DEUniversity of Bristol · GBUniversity of California San Diego · USUniversity of Oxford · GBVrije Universiteit Amsterdam · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeRecent work showed an increased risk of cervical and lumbar intervertebral disc (IVD) herniations in astronauts. The European Space Agency asked the authors to advise on the underlying pathophysiology of this increased risk, to identify predisposing factors and possible interventions and to suggest research priorities.

methodsThe authors performed a narrative literature review of the possible mechanisms, and conducted a survey within the team to prioritize research and prevention approaches. RESULTS AND

conclusionsBased on literature review the most likely cause for lumbar IVD herniations was concluded to be swelling of the IVD in the unloaded condition during spaceflight. For the cervical IVDs, the knowledge base is too limited to postulate a likely mechanism or recommend approaches for prevention. Basic research on the impact of (un)loading on the cervical IVD and translational research is needed. The highest priority prevention approach for the lumbar spine was post-flight care avoiding activities involving spinal flexion, followed by passive spinal loading in spaceflight and exercises to reduce IVD hyper-hydration post-flight.

Indexed as

AstronautsCervical VertebraeLumbar VertebraeSpace FlightHumansIntervertebral Disc DisplacementRisk FactorsAtrophyBack painBed restInactivityMuscleProlapse

Identifiers

PMID25893331
OpenAlexW2010618861

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.