Spine Phenotypes

Spine Phenotypes

1st Edition - July 8, 2022

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  • Editors: Dino Samartzis, Jaro Karppinen, Frances Williams
  • eBook ISBN: 9780128227794
  • Hardcover ISBN: 9780128227787

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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.

Key Features

  • Book chapters devoted to specific imaging phenotypes with discussion of their clinical correlates
  • Imaging phenotypes provided with examples of established phenotypic measurements and a range of normal and pathologic images
  • Multiauthor, multidisciplinary contributions comprising world leaders in the field of spine imaging, research, and clinical practice


Researchers, Orthopedists, Spine Specialists (including chiropractors, physiatrists, physical therapists, neurosurgeons, pain management physicians and many rheumatologists and neurologists). Medical Students, Nurses, Residents, Physician Assistants, and Undergraduate Students

Table of Contents

  • 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

Product details

  • No. of pages: 416
  • Language: English
  • Copyright: © Academic Press 2022
  • Published: July 8, 2022
  • Imprint: Academic Press
  • eBook ISBN: 9780128227794
  • Hardcover ISBN: 9780128227787

About the Editors

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 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 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

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