Intervertebral Disc Magnetic Resonance Spectroscopy Changes After Spinal Manipulative Therapy for Lumbar Discogenic Pain.

Autor:	Billham JF; Department of Radiology, Logan University, Chesterfield, USA., Shi D; Department of Radiology, Logan University, Chesterfield, USA., Evans Roland E; Department of Clinical Chiropractic, Montgomery Health Center, Logan University, Chesterfield, USA., Gornet MF; Department of Orthopedics, The Orthopedic Center of St Louis, St Louis, USA., Brinkman KK; Department of Chiropractic, College of Chiropractic, Logan University, Chesterfield, USA., Schranck FW; Department of Research, SPIRITT Research, St Louis, USA., Cox JM; Department of Radiology and Clinical Chiropractic, Cox Chiropractic Medicine, Fort Wayne, USA., Kettner NW; Department of Radiology, Logan University, Chesterfield, USA.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2024 Oct 23; Vol. 16 (10), pp. e72225. Date of Electronic Publication: 2024 Oct 23 (Print Publication: 2024).
DOI:	10.7759/cureus.72225
Abstrakt:	This study investigates the use of magnetic resonance spectroscopy (MRS) to identify the intervertebral disc (IVD) as a pain generator, explore the pathophysiology of the biochemical and structural components of discogenic low back pain (DLBP), and present potential evidence of physiological responses to spinal manipulation therapy (SMT). A 29-year-old male presented with uncomplicated low back pain (LBP). The non-specific presentation and clinical examination findings were consistent with an initial working diagnosis of non-specific LBP with the clinician suspecting IVD as a likely pain generator. Conventional magnetic resonance imaging showed findings of IVD degeneration including Modic type I changes consistent with a diagnosis of DLBP. MRS was utilized for structural and biochemical analysis of the IVDs. Altered spectral features confirmed a DLBP diagnosis. The patient underwent 16 Cox flexion-distraction SMT treatments at a chiropractic teaching clinic in Chesterfield, Missouri. A follow-up MRS was performed to compare and evaluate post-treatment results. We report the utilization of MRS to quantify the structural integrity and biochemical pain profile of the IVD in a conservatively managed chronic DLBP patient who was unresponsive to previous steroid injections. Comparison between MRS revealed improved IVD spectral features including decreased biochemical pain markers and increased glycoprotein biosynthesis. This implies that the SMT management of chronic DLBP may improve IVD structural integrity and alter pain biochemistry. Competing Interests: Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: Erika Evans Roland, Matthew F Gornet, Francine W Schranck declare(s) stock/stock options from Aclarion. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work. (Copyright © 2024, Billham et al.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu