{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T02:54:23Z","timestamp":1789700063994,"version":"4.0.1"},"reference-count":30,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2022,8,5]],"date-time":"2022-08-05T00:00:00Z","timestamp":1659657600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["K24 AG036778"],"award-info":[{"award-number":["K24 AG036778"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["R21 AG058348"],"award-info":[{"award-number":["R21 AG058348"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["agsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J American Geriatrics Society"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Lumbar spinal stenosis (LSS) is a common reason for spine surgery in which ligamentum flavum is resected. Transthyretin (TTR) amyloid is an often unrecognized and potentially modifiable mechanism for LSS that can also cause TTR cardiac amyloidosis. Accordingly, older adult patients undergoing lumbar spine (LS) surgery were evaluated for amyloid and if present, the precursor protein, as well as comprehensive characterization of the clinical phenotype.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A prospective, cohort study in 2 academic medical centers enrolled 47 subjects (age 69\u2009\u00b1\u20097\u2009years, 53% male) undergoing clinically indicated LS decompression. The presence of amyloid was evaluated by Congo Red staining and in those with amyloid, precursor protein was determined by laser capture microdissection coupled to mass spectrometry (LCM\u2010MS). The phenotype was assessed by disease\u2010specific questionnaires (Swiss Spinal Stenosis Questionnaire and Kansas City Cardiomyopathy Questionnaire) and the 36\u2010question short\u2010form health survey, as well as biochemical measures (TTR, retinol\u2010binding protein, and TTR stability). Cardiac testing included technetium\u201099m\u2010pyrophosphate scintigraphy, electrocardiograms, echocardiograms, and cardiac biomarkers as well as measures of functional capacity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Amyloid was detected in 16 samples (34% of participants) and was more common in those aged\u2009\u2265\u200975\u2009years of age (66.7%) compared with those &lt;75\u2009years (22.3%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). LCM\u2010MS demonstrated TTR as the precursor protein in 62.5% of participants with amyloid while 37.5% had an indeterminant type of amyloid. Demographic, clinical, quality\u2010of\u2010life measures, electrocardiographic, echocardiographic, and biochemical measures did not differ between those with and without amyloid. Among those with TTR amyloid (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a010), one subject had cardiac involvement by scintigraphy.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Amyloid is detected in more than a third of older adults undergoing LSS. Amyloid is more common with advancing age and is particularly common in those &gt;75\u2009years old. No demographic, clinical, biochemical, or cardiac parameter distinguished those with and without amyloid. In more than half of subjects with LS amyloid, the precursor protein was TTR indicating the importance of pathological assessment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.17976","type":"journal-article","created":{"date-parts":[[2022,8,5]],"date-time":"2022-08-05T03:36:09Z","timestamp":1659670569000},"page":"3538-3548","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":39,"title":["Analysis of lumbar spine stenosis specimens for identification of amyloid"],"prefix":"10.1111","volume":"70","author":[{"given":"Mathew S.","family":"Maurer","sequence":"first","affiliation":[{"name":"Columbia University Irving Medical Center\/New York Presbyterian Hospital Scripps Clinic, Tufts Medical Center  New York, New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dia","family":"Smiley","sequence":"additional","affiliation":[{"name":"Columbia University Irving Medical Center\/New York 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Medical Center\/New York Presbyterian Hospital Scripps Clinic, Tufts Medical Center  New York, New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jon T.","family":"Giles","sequence":"additional","affiliation":[{"name":"Columbia University Irving Medical Center\/New York Presbyterian Hospital Scripps Clinic, Tufts Medical Center  New York, New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffery W.","family":"Kelly","sequence":"additional","affiliation":[{"name":"Columbia University Irving Medical Center\/New York Presbyterian Hospital Scripps Clinic, Tufts Medical Center  New York, New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felix","family":"Tsai","sequence":"additional","affiliation":[{"name":"Columbia University Irving Medical Center\/New York Presbyterian Hospital Scripps Clinic, Tufts Medical Center  New York, New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William S.","family":"Blaner","sequence":"additional","affiliation":[{"name":"Columbia University Irving Medical Center\/New York Presbyterian Hospital Scripps Clinic, Tufts Medical Center  New York, New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre\u2010Jacques","family":"Brun","sequence":"additional","affiliation":[{"name":"Columbia University Irving Medical Center\/New York Presbyterian Hospital Scripps Clinic, Tufts Medical Center  New York, New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ron I.","family":"Riesenburger","sequence":"additional","affiliation":[{"name":"Columbia University Irving Medical Center\/New York Presbyterian Hospital Scripps Clinic, Tufts Medical Center  New York, New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Kryzanski","sequence":"additional","affiliation":[{"name":"Columbia 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