• Zhiguo Liu, Jianwen Li, Minghsien Hu, Xiaoshuai Wang, Ningning Chen, Shangbin Cui, Songbo Li, Hanzhong Liu, Guoliang Chen, Ximin Pan, Haixing Sun, Shaoyu Liu, and Fuxin Wei.
• Department of Neurosurgery, People's Hospital of Zhangqiu, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China.
• Spine. 2020 Nov 15; 45 (22): E1451-E1459.

Study DesignAnimal experimental study.ObjectiveThe aim of this study was to investigate the optimal time of hydrogel injection for regenerating intervertebral disc degeneration (IDD) based on T1ρ magnetic resonance imaging (MRI).Summary Of Background DataCurrently, different approaches are being pursued to regenerate the IDD. However, the optimal timing for the regenerative intervention is unclear.MethodsThe slowly, progressive IDD models were established in 18 rhesus monkeys. On the basis of the MR T1ρ values of the discs, the rhesus monkeys were divided into severe (T1ρ values: <81 ms), moderate (T1ρ values: 81∼95 ms), and mild (T1ρ values: 96∼110 ms) degeneration groups. Biocompatible hydrogel was injected into the central part of the nucleus pulposus of the discs under fluoroscopic guidance. Treatment effects were investigated using radiography, T1ρ MRI, and histology until 12 months postoperatively.ResultsAfter injection, the T1ρ values of all the discs increased significantly at 1 month postoperatively, and then remained at approximately 110 ms in the mild and moderate groups during the whole observation period, with no significant difference compared to the values at 1 month (P > 0.05). However, in the severe group, the T1ρ values decreased significantly after 1 month and leveled at approximately 70 ms after 6 months, with significant difference compared to the values at 1 month (P < 0.05). In the mild and moderate groups, there were no significant differences between preoperative histological scores and those at 12 months (P > 0.05). However, the histological score in the severe group at 12 months was significantly higher than the preoperative scores (P < 0.05).ConclusionThis study suggested that the moderate degenerative stage of IDD (T1ρ values from 95 to 80 ms) could be the optimal time for hydrogel injection aimed at the regenerative intervention, based on T1ρ-MR imaging technique and quantitative analysis.Level Of EvidenceN/A.

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