Risk of Intervertebral Disc Damage after Prolonged Space Flight (Intervertebral Disc Damage) - 12.03.13
Science Objectives for Everyone
The goal of this study is to use state-of-the-art imaging technologies to comprehensibly characterize and quantify space-flight induced changes in disc morphology, biochemistry, metabolism, and kinematics. Subjects will be imaged before and after prolonged spaceflight. These data will be correlated with low back pain that spontaneously arises in space so as to establish pain and disc damage mechanisms that will serve as a basis for future countermeasure development.
Science Results for Everyone
OpNom: N/APrincipal Investigator(s)
Johnson Space Center, Human Research Program, Houston, TX, United States
National Aeronautics and Space Administration (NASA)Sponsoring Organization
Human Exploration and Operations Mission Directorate (HEOMD)Research Benefits
Information PendingISS Expedition Duration:
September 2012 - September 2014Expeditions Assigned
33/34,35/36,37/38,39/40,41/42,43/44Previous ISS Missions
- The proposed measures represent a comprehensive set of tests that evaluate exposure severity, potential injury mechanisms, and pain generator localization. This research will aid understanding of spinal pain and deconditioning during prolonged microgravity and of the higher incidence of disc prolapse or herniation following re-exposure to 1-G with a long-term view to prevent such spinal deconditioning with exercise or other physiologic countermeasures.
- After successful completion of the investigation, the PI team will deliver a comprehensive database of microgravity-induced intervertebral disc and vertebral changes (type and magnitude) and a prioritization of these changes as to their deleterious effects and risks for crew member injury based on clinical findings.
- Importantly, this research will have application to back-pain patients on Earth in general and specifically, to patients exposed to long-term bed rest or lack of mobility (spinal-cord injury patients as well as patients suffering lack of exercise, mobility and obesity). This research also has application to abnormal spinal curvature and pain suffered by children wearing heavy backpacks to and from school.
Pre-flight and Post-flight BDC consists of a battery of 6 tests:
- MRI (Morphology/Water Content): Once pre-flight, and post-flight on R+1 and R+30 MRI scans will be taken while lying flat on the back on a MRI table to measure the spinal bones, discs and muscles. MRI scans will be taken of the lumbar and cervical spine.
- MRS: Once pre-flight and post-flight on R+1 and R+30 MR spectroscopy will measure metabolites in spinal disc tissues of the lumbar spine.
- MRI (Axial Load): Once pre-flight and once post-flight in the R+3-5 timeframe, the subject will visit the Stand-Up MRI in Clear Lake, Texas for an upright MRI study. Here, the PI team will take MRI scans in four different conditions. First, they will take scans lying flat on the back on a MRI table. Second, they will take scans standing in upright posture without any load on the back. Third, they will take scans standing in the same upright posture but with 10% of body weight loaded on the back. Fourth, they will take off the backpack and then take scans of cervical spine while the subject is in a seated position.
- Spinal Kinematics: Once pre-flight and once post-flight in the R+3-5 timeframe, the PI team will measure the lumbar spine stiffness and stability using the KineGraph Vertebral Motion Analyzer (VMA). The KineGraph VMA is a system that measures the motion of the bones in the spine using a standard fluoroscope. A fluoroscope is an FDA-approved imaging machine that has been in widespread use for decades, and is used to collect moving video X-ray images of the motion of the spine. In addition to a fluoroscope, the KineGraph VMA also involves the use of a large patient handling device that will assist the subject through a series of controlled spine bends while the fluoroscope is collecting images. These large patient handling devices are needed to standardize the bending, so that it is possible to compare the subject’s spine motion to that of other people. The study consists of taking a series of video X-rays as the subject does different types of spine bending while assisted by the large patient handling devices. The subject will do forward and backward bending, side-to-side bending, bending while standing up, and bending while lying down. To ensure the subject can comfortably do all of these bends, he or she will be asked to perform each of these bends on his or her own before being assisted by the patient handling devices.
- Biering-Sorenson: Twice pre-flight (in the same session) and once post-flight in the R+3-7 timeframe the subject will also perform a strength test of the abdominal and back muscles.
- Back Pain Questionnaire: Once pre-flight and once post-flight in the R+1-7 timeframe the subject will answer two questionnaires.
State-of-the-art, non-invasive imaging technologies will be used to quantify morphology, biochemistry, metabolism, and kinematics for cervical and lumbar discs of crew members before and after prolonged space flight. Importantly, these data will be correlated with low back pain that spontaneously arises during prolonged microgravity and after re-adaptation to Earth gravity, so as to establish pathomechanisms that will serve as a basis for future countermeasure development. After successful completion of this investigation, a comprehensive database of microgravity-induced intervertebral disc and vertebral changes (type and magnitude) will be delivered along with a prioritization of these changes as to their deleterious effects and risks for crew member injury based on clinical findings.Earth Applications
Importantly, this research will have application to back-pain patients on Earth in general and specifically, to patients exposed to long-term bed rest or lack of mobility (spinal-cord injury patients as well as patients suffering lack of exercise, mobility and obesity). This research also has application to abnormal spinal curvature and pain suffered by children wearing heavy backpacks to and from school.
Twelve subjects are requested to perform the preflight and postflight baseline data collection for IVD.Operational Protocols
This investigation only requires baseline data collection (BDC) both preflight and postflight. No inflight testing will occur.