• Spine · Jun 2014

    Early pattern of degenerative changes in individual components of intervertebral discs in stressed and nonstressed segments of lumbar spine: an in vivo magnetic resonance imaging study.

    • Aseem Sharma, Samantha Lancaster, Swapnil Bagade, and Charles Hildebolt.
    • *Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO; †Department of Radiology, Barnes-Jewish Hospital South, St. Louis, MO; and ‡Department of Radiology, St. Louis Children's Hospital, St. Louis MO.
    • Spine. 2014 Jun 1;39(13):1084-90.

    Study DesignA retrospective imaging review.ObjectiveTo assess differences in burden and pattern of disc degeneration in segments of lumbar spine with and without signs of increased mechanical stresses.Summary Of Background DataYoung patients with magnetic resonance imaging signs of increased mechanical stress in pedicles or pars interarticularis provide an excellent in vivo model to study early effects of mechanical stresses on lumbar intervertebral discs without the confounding effects of genetics or environmental factors. Detailed in vivo evaluation for early degenerative changes in all individual disc components of stressed intervertebral discs has not been done.MethodsUsing magnetic resonance imaging, 2 radiologists assessed intervertebral discs around 93 stressed lumbar spinal segments in 87 patients (55 males, 32 females; mean age, 15.3 ± 3.3 yr; range, 5-25 yr) as well as lumbar discs in nonstressed segments for signs of degeneration in annulus fibrosus, nucleus pulposus, and endplates. Differences between stressed, control, and loading-matched control discs were assessed using Wilcoxon signed rank sum test.ResultsBurden of annular tears, radial tears, herniations, and nuclear degeneration was significantly higher in stressed discs (0.70 ± 0.34, 0.48 ± 0.39, 0.07 ± 0.19, and 0.17± 0.31, respectively) than control (0.29 ± 0.25, 0.09 ± 0.17, 0.01 ± 0.04, and 0.02 ± 0.08, respectively) or loading-matched control discs (0.44 ± 0.47, 0.16 ± 0.36, 0.01 ± 0.04, and 0.01 ± 0.11, respectively) (P < 0.01 for all). Stressed segments did not show any significant increase in endplate degeneration.ConclusionIntervertebral discs in stressed spinal segments show an increased burden of disc degeneration involving annulus fibrosus and nucleus pulposus, but not the endplates.Level Of EvidenceN/A.

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