European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
-
Quantitative MRI techniques were utilized to study intervertebral disc degeneration. Main focus was to develop a novel approach to quantify disc height loss associated with disc degeneration. Currently there is no universally accepted metric of degeneration based on measurement of disc height. Such quantitative imaging methods would complement qualitative visual assessment methods currently used and offer a valuable diagnostic tool. ⋯ This study provides new, unbiased quantitative imaging tools to assess disc degeneration. We observed that these quantitative MRI measures indicate a threshold beyond which major pathological changes take place concurrently. Combined information from DHI, ADC and T2 images construct a set of novel biomarkers that could be used to identify degenerating discs that are approaching the threshold and possibly intervene before major pathologic changes occur.
-
To investigate the regional tensile properties of human annulus fibrosus (AF) and relate them to magnetic resonance imaging (MRI) findings. ⋯ Weakening of degenerated AF may be caused by accumulating structural defects, and enzymatic degradation. MRI has the potential to identify local weakening of the AF.
-
To analyze the effects of mobility of degenerated disc in the lower lumbar discs (L4-5 and L5-S1) on both whole lumbar motion and adjacent segment ROM. ⋯ Degenerated lumbar discs did not show hypermobility within functional ROM. Loss of segmental ROM from advanced disc degeneration did not cause an increase in the ROM of the superior adjacent segment in vivo. When the LLS had motion-lost, advanced disc degeneration, whole lumbar motion was significantly decreased and compensatory increase in ROM was accomplished by the ULS.
-
To investigate whether exogenous tumor necrosis factor-α (TNF-α) will initiate a degenerative process in intervertebral disc in vivo. ⋯ Intradiscal injection of exogenous TNF-α caused early stage disc degeneration in a porcine model. It may thus support the hypothesis of exogenic TNF-α being an important early pathogenetic factor in disc degeneration.
-
Observational Study
Health care costs of incidental durotomies and postoperative cerebrospinal fluid leaks after elective spinal surgery.
To explore the additional health care costs of incidental durotomies and cerebrospinal fluid (CSF) leaks after elective surgery for degenerative spinal disorders. ⋯ Incidental durotomy or postoperative cerebrospinal fluid leak after elective surgery for degenerative spinal disorders causes significantly higher health care costs.