Discovery unlocks spine disease mysteries

Special to Western NewsLed by Schulich School of Medicine & Dentistry professor Cheryle Seguin, a Bone and Joint Institute research team has made a breakthrough into better understanding a highly prevalent spine disease that affects one-third of North American men over 50.

Sufferers of a common spine disease affecting one-third of North American men over 50 may find hope in new therapies and treatments thanks to a breakthrough from an interdisciplinary team of scientists and medical practitioners from the Bone and Joint Institute.

Diffuse idiopathic skeletal hyperostosis – more commonly known as DISH – occurs when ligaments and connective tissues harden along the spine. Despite its relatively high level of pervasiveness, little was known about the disease – until now.

One long-held belief about DISH was that it was new bone growth between the spine’s vertebrae that was causing the moderate to severe back pain and stiffness.

Led by Schulich School of Medicine & Dentistry professor Cheryle Seguin, the research team examined spines from human cadavers and discovered the growths leading to a DISH diagnosis are, in fact, not always new bone growth – they can sometimes be hyperdense calcified deposits. The appearance of these tissues by micro-CT also suggests this process may not be limited to conventional new bone formation.

The study, Ectopic spinal calcification associated with diffuse idiopathic skeletal hyperostosis (DISH): A quantitative micro‐ct analysis, was published in the February 2019 edition of the Journal of Orthopaedic Research.

Séguin recruited surgeons, radiologists and physiotherapists from the Bone and Joint Institute, as well as patients suffering from DISH, to develop a holistic approach to understanding the disease.

The Canadian Institutes of Health Research (CIHR) New Investigator Award winner also recently completed a corroborating study, published by the Journal of Cellular Physiology, using mouse models to examine the cellular changes that might contribute to the onset of DISH. The same calcification process occurred in the mice.

“DISH is an extremely common disease yet it is severely understudied,” Séguin said. “We can learn things from the cadavers, but it is limited because these aren’t living specimens. The mouse model is limited too because it’s not human.

“But when you combine those two studies together, that’s when it gets really exciting. We now have a clear pathway on where to go from here to better understanding DISH and developing new therapies and treatments.”

While DISH occurs most commonly in the spine, it can affect almost any part of the skeleton, including hips, knees, ankles, feet, shoulders, hands and ribs. The most common symptoms are pain, stiffness and reduced range of motion.