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Medical Forum / General / Cardiology / July 2005how statins may cause and/or worsen spinal stenois
Statins may cause and/or worsen spinal stenosis. This study indicates STATINS promote bone formation. Stenosis is new bone formation (thickned bone) and possible attendent nerve compression in the spinal nerve canal. Zee http://www.ncbi.nlm.nih.gov/en trez/query.fcgi?cmd=Retrieve&d b=pubmed&... "New bone formation and bone thickness were significantly enhanced following simvastatin treatment." Biomaterials. 2005 Oct;26(29):5783-9. Promotion of bone formation by simvastatin in polyethylene particle-induced osteolysis. von Knoch F, Wedemeyer C, Heckelei A, Saxler G, Hilken G, Brankamp J, Sterner T, Landgraeber S, Henschke F, Loer F, von Knoch M. Department of Orthopaedic Surgery, Kantonsspital Chur, Loestrasse 170, 7000 Chur, Switzerland. fabianvonkn...@yahoo.com The effcts of statins on bone formation in periprosthetic osteolysis have not been determined to date. We investigated the effect of the HMG-CoA reductase inhibitor simvastatin on osteoblastic bone formation under conditions of ultra-high molecular weight polyethylene (UHMWPE) particle-induced osteolysis. The murine calvarial osteolysis model was utilized in 21 C57BL/J6 mice randomized to three groups. Group I underwent sham surgery only, group II received UHMWPE particles, and group III, particles and simvastatin treatment. After 2 weeks, calvaria were processed for histomorphometry and stained with Giemsa dye. New bone formation was measured as osteoid tissue area within the midline suture. Bone thickness was quantified as indicator of net bone growth. Statistical analysis was performed using one-way ANOVA and a Student's t-test. New bone formation and bone thickness were significantly enhanced following simvastatin treatment. New bone formation was 0.008+/-0.008 mm2 in sham controls (group I), 0.015+/-0.012 mm2 after particle implantation without further intervention (group II), compared to 0.083+/-0.021 mm2 with particle implantation and simvastatin treatment (group III) (p=0.003). The bone thickness was 0.213+/-0.007 mm in group I, 0.183+/-0.005 mm in group II, and 0.238+/-0.009 mm in group III (p=0.00008). In conclusion, simvastatin treatment markedly promoted bone formation and net bone growth in UHMWPE particle-induced osteolysis in a murine calvarial model. These new findings indicate that simvastatin may have favorable osteoanabolic effects on wear debris-mediated osteolysis after total joint arthroplasty, involving local stimulation of osteoblastic bone formation. PMID: 15869791 [PubMed - in process] > Statins may cause and/or worsen spinal stenosis. This study indicates > STATINS promote bone formation. Stenosis is new bone formation > (thickned bone) and possible attendent nerve compression in the spinal > nerve canal. Zee spinal stenosis is NOT new bone formation..but a narrowing of the vertebral column...causing years and years to develop..and yes,,can eventually cause nerve root compression and pain it cannot ..does not..occur or worsen in three months of ANY drug therapy.... > http://www.ncbi.nlm.nih.gov/en trez/query.fcgi?cmd=Retrieve&d > b=pubmed&... [quoted text clipped - 45 lines] > > PMID: 15869791 [PubMed - in process] Hawki, I'm a little confused. How can the study get valid measurable results, sufficient to pass the editorial jury of peers and get into print, after reportedly only 2 weeks? Also, how can we be certain that the thickening of a bone would be only on the outside? If a donut shaped bone thickened, might it not thicken throughout and thereby reduce the diameter of the 'donut hole'? Did the paper specify? Do you have access to the full text version? >> Statins may cause and/or worsen spinal stenosis. This study indicates >> STATINS promote bone formation. Stenosis is new bone formation [quoted text clipped - 57 lines] >> >> PMID: 15869791 [PubMed - in process] > Hawki, > > I'm a little confused. How can the study get valid measurable results, > sufficient to pass the editorial jury of peers and get into print, after > reportedly only 2 weeks? it was a preliminary study...very preliminary... > Also, how can we be certain that the thickening of a bone would be only on > the outside? If a donut shaped bone thickened, might it not thicken > throughout and thereby reduce the diameter of the 'donut hole'? theoritically...it could...however..this abstract was sooo short and statistically insignificant..who knows?? again..spinal stenosis takes YEARS to develop and years to worsen..Rita's situation involved taking statins for a mere 3.5 months..significant bone growth enough to cause her symptom changes...are unlikely.. > Did the paper specify? Do you have access to the full text version? the paper specified WHERE this new bone growth occurred and was measured... it specified (which Zee quoted but did not comment upon) "These new findings indicate that simvastatin MAY have favorable osteoanabolic effects on wear debris mediated osteolysis AFTER total joint arthroplasty,,involving local stimulation of osteoblastic bone formation" comments: note the MAY have .....snip note also that this study ONLY after total joint etc etc in other words...it may not have been the statins AT ALL...as ALL joint replacements begin to build new bones at the "midline suture" (quote from the abstract)..even WITHOUT any added meds...this is the physiology of how joint replacements work surely at the two week mark..it is impossible to conclude that it WAS the statins added that accounted for the change..in fact..note that the difference was less than signifcance level which is .05...so even if there WAS a difference it was minute..and can be attributed to other issues..ie age and health of the patient..etc >>> Statins may cause and/or worsen spinal stenosis. This study indicates >>> STATINS promote bone formation. Stenosis is new bone formation [quoted text clipped - 57 lines] >>> >>> PMID: 15869791 [PubMed - in process] It seems to me I heard somewhere that Sharon Hope wrote in article <nYSdnWoIh4tCqHHfRVn-vg@comcast.com>: >Hawki, >I'm a little confused. How can the study get valid measurable results, >sufficient to pass the editorial jury of peers and get into print, after >reportedly only 2 weeks? These were mouse studies ("The murine calvarial osteolysis model was utilized in 21 C57BL/J6 mice randomized to three groups.". Mice have different growth rates than humans. Since they were *mouse* studies, do you and Zee really want to put much emphasis on the results or read "stenosis" into them?  SignatureDon Kirkman >It seems to me I heard somewhere that Sharon Hope wrote in article ><nYSdnWoIh4tCqHHfRVn-vg@comcast.com>: [quoted text clipped - 11 lines] >Since they were *mouse* studies, do you and Zee really want to put much >emphasis on the results or read "stenosis" into them? It occurred to me that mice have different growth rates than humans also. Look at the difference in life spans. I have a daughter who has had little rats as pets -- and every few months she Emails me that she is mourning one of her pets that has died. She seems not to realize that mice/rats do not have a long life span. House mice live about 1-2 years on average. The Methuselah mouse contest is a competition to breed or engineer extremely long-lived laboratory mice. As of 2004, the record holder was a genetically engineered mouse that lived for 1819 days, nearly 5 years. The fact that they go through the maturation and birth cycles quickly makes them excellent for research purposes - but can one apply the same time cycles mice experience to humans? I would think not. The mouse/statin study seems an interesting bit that perhaps researchers will pursue further. No more, no less. I wouldn't want to wave it at my doctor and say, "Look, doc, these mice developed bone after statins in just 5 weeks. So obviously that's what happened to me to cause my stenosis after taking Zocor for 3-1/2 months." Would you do that? Would anyone? > Statins may cause and/or worsen spinal stenosis. This study indicates > STATINS promote bone formation. Stenosis is new bone formation > (thickned bone) and possible attendent nerve compression in the spinal > nerve canal. Zee That study has nothing to do with your premise that it causes nerve compression. You have turned into an ambulance chaser competing with lawyers now. Couldn't this be read as how statins may prevent bone fractures in the aging? Bill > Statins may cause and/or worsen spinal stenosis. This study indicates > STATINS promote bone formation. Stenosis is new bone formation [quoted text clipped - 50 lines] > > PMID: 15869791 [PubMed - in process] > Couldn't this be read as how statins may prevent bone fractures in the aging? > > Bill Certainly they are going to look for ways to use this. But statins are not a good bet in the aging, particularly if they don't have cardiovascular disease. There is too much risk to the risk/benefit ratio. Zee > > Statins may cause and/or worsen spinal stenosis. This study indicates > > STATINS promote bone formation. Stenosis is new bone formation [quoted text clipped - 50 lines] > > > > PMID: 15869791 [PubMed - in process] It seems to me I heard somewhere that zee wrote in article <1122768067.035898.258930@o13g2000cwo.googlegroups.com>: >> Couldn't this be read as how statins may prevent bone fractures in the aging? I suggested the beneficial effects of bone regeneration; glad I wasn't alone in interpreting it that way. >Certainly they are going to look for ways to use this. But statins are >not a good bet in the aging, particularly if they don't have >cardiovascular disease. There is too much risk to the risk/benefit >ratio. I assume you have a peer-reviewed citation for this. Since cardiac problems tend to increase with age I would suspect the population of statin users may be tilted toward older folks. SignatureDon Kirkman > It seems to me I heard somewhere that zee wrote in article > <1122768067.035898.258930@o13g2000cwo.googlegroups.com>: [quoted text clipped - 12 lines] > problems tend to increase with age I would suspect the population of > statin users may be tilted toward older folks. I sure do. Do you own research. Zee |
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