Evidence map›Paper›PMID 26281980›Full record

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

Age and pro-inflammatory gene polymorphisms influence adjacent segment disc degeneration more than fusion does in patients treated for chronic low back pain.

Ahmad Omair, Anne F Mannion, Marit Holden, Gunnar Leivseth, Jeremy Fairbank, Olle Hägg, Peter Fritzell, Jens I Brox

Abstract read
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In one paragraph

Article 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 14 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
14citing papers in PubMed, 4 pooled it
4.5field-weighted citation impact, top 6% 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

14 citing papers in PubMed, 4 syntheses or guidelines pooled it, 29 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Vitamin D receptor gene polymorphisms and lumbar disc degeneration: a systematic review and meta-analysis.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 · 2017
    Pooled it
  4. Adjacent segment degeneration after lumbar spinal fusion compared with motion-preservation procedures: a meta-analysis.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
    Pooled it
  5. Trial
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  8. Etiology-Based Classification of Adjacent Segment Disease Following Lumbar Spine Fusion.HSS journal : the musculoskeletal journal of Hospital for Special Surgery · 2020
    Article
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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

8 authors at 7 institutions in 4 countries.

Ahmad OmairDepartment of Orthopaedics, Oslo University Hospital-Rikshospitalet, Oslo, Norway. dr.ahmad.omair@gmail.com.
Anne F MannionDepartment of Research and Development, Spine Center Division, Schulthess Klinik, Zurich, Switzerland.
Marit HoldenNorwegian Computing Centre, Blindern, Oslo, Norway.
Gunnar LeivsethInstitute of Clinical Medicine, Neuromuscular Disorders Research Group, UiT the Arctic University of Norway, Tromsø, Norway.
Jeremy FairbankNuffield Orthopaedic Centre, University of Oxford, Oxford, UK.
Olle HäggSpine Center Göteborg, Gothenburg, Sweden.
Peter FritzellNeuro-Orthopedic Center, Länssjukhuset Ryhov, Jönköping, Sweden.
Jens I BroxDepartment of Physical Medicine and Rehabilitation, Oslo University Hospital, University of Oslo, Oslo, Norway.
Norwegian Computing Center · NONuffield Orthopaedic Centre · GBRegion Jönköpings län · SESchulthess-Klinik · CHSpine Center Göteborg · SEUiT The Arctic University of Norway · NOUniversity of Oslo · NO

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeDoes lumbar fusion lead to accelerated adjacent segment disc degeneration (ASDD) or is it explained by genetics and aging? The influence of genetics on ASDD remains to be explored. This study assesses whether the disc space height adjacent to a fused segment is associated with candidate gene single nucleotide polymorphisms (SNPs).

methodsPatients with low back pain from four RCTs (N = 208 fusion; 77 non-operative treatment) underwent standing plain radiography and genetic analyses at 13 ± 4 years follow-up. Disc space height was measured using a validated computer-assisted distortion-compensated roentgen analysis technique and reported in standard deviations from normal values. Genetic association analyses included 34 SNPs in 25 structural, inflammatory, matrix degrading, apoptotic, vitamin D receptor and OA-related genes relevant to disc degeneration. These were analysed for their association with disc space height (after adjusting for age, gender, smoking, duration of follow-up and treatment group) first, separately, and then together in a stepwise multivariable model.

resultsTwo SNPs from the IL18RAP gene (rs1420106 and rs917997) were each associated with a lower disc space height at the adjacent level (B = -0.34, p = 0.04 and B = -0.35, p = 0.04, respectively) and the MMP-9 gene SNP rs20544 was associated with a greater disc space height (B = 0.35, p = 0.04). Age (p < 0.001) and fusion (p < 0.008) were also significant variables in each analysis. The total explained variance in disc space height was for each SNP model 13-14 %, with 11-12 % of this being accounted for by the given SNP, 64-67 % by age and 19-22 % by fusion. In the multivariable regression analysis (with nine SNPs selected for entry, along with the covariates) the total explained variance in disc space height was 23 %, with the nine SNPs, age and fusion accounting for 45, 45 and 7 % of this, respectively.

conclusionsAge was the most significant determinant of adjacent segment disc space height followed by genetic factors, specifically inflammatory genes. Fusion explained a statistically significant but small proportion of the total variance. Much of the variance remained to be explained.

Indexed as

AgingPolymorphism, Single NucleotideAdolescentAdultAgedChronic PainFemaleFollow-Up StudiesHumansInterleukin-18 Receptor beta SubunitIntervertebral DiscIntervertebral Disc DegenerationLow Back PainLumbar VertebraeMaleMatrix Metalloproteinase 9IL18RAP protein, humanInterleukin-18 Receptor beta SubunitMatrix Metalloproteinase 9Adjacent segment disc degenerationChronic low back painInflammatory genesLumbar fusionSingle nucleotide polymorphism

Identifiers

PMID26281980
OpenAlexW1161502761

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.