The contributions of cartilage endplate composition and vertebral bone marrow fat to intervertebral disc degeneration in patients with chronic low back pain
| Autor: | Jeffrey C. Lotz, N. B. Bonnheim, R. Chachad, Aaron J. Fields, C. O'Neill, Ann A. Lazar, J. Zhou, R. Krug, T. M. Link, L. Wang, X. Guo, C. Iriondo, N. Sollmann |
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| Rok vydání: | 2022 |
| Předmět: |
Adult
Male medicine.medical_specialty Aging Clinical Sciences Urology Biomedical Engineering Degeneration (medical) Intervertebral Disc Degeneration Cartilage endplate Bone Marrow Clinical Research Vertebral bone marrow Medicine Humans In patient Orthopedics and Sports Medicine Quantitative magnetic resonance imaging Intervertebral Disc Lumbar Vertebrae business.industry Cartilage Pain Research Intervertebral disc Middle Aged Magnetic Resonance Imaging Chronic low back pain medicine.anatomical_structure Orthopedics Musculoskeletal Content (measure theory) Biomedical Imaging Surgery Female Chronic Pain business Perfusion Low Back Pain |
| Zdroj: | 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, vol 31, iss 7 |
| Popis: | Purpose The composition of the subchondral bone marrow and cartilage endplate (CEP) could affect intervertebral disc health by influencing vertebral perfusion and nutrient diffusion. However, the relative contributions of these factors to disc degeneration in patients with chronic low back pain (cLBP) have not been quantified. The goal of this study was to use compositional biomarkers derived from quantitative MRI to establish how CEP composition (surrogate for permeability) and vertebral bone marrow fat fraction (BMFF, surrogate for perfusion) relate to disc degeneration. Methods MRI data from 60 patients with cLBP were included in this prospective observational study (28 female, 32 male; age = 40.0 ± 11.9 years, 19–65 [mean ± SD, min–max]). Ultra-short echo-time MRI was used to calculate CEP T2* relaxation times (reflecting biochemical composition), water-fat MRI was used to calculate vertebral BMFF, and T1ρ MRI was used to calculate T1ρ relaxation times in the nucleus pulposus (NP T1ρ, reflecting proteoglycan content and degenerative grade). Univariate linear regression was used to assess the independent effects of CEP T2* and vertebral BMFF on NP T1ρ. Mixed effects multivariable linear regression accounting for age, sex, and BMI was used to assess the combined relationship between variables. Results CEP T2* and vertebral BMFF were independently associated with NP T1ρ (p = 0.003 and 0.0001, respectively). After adjusting for age, sex, and BMI, NP T1ρ remained significantly associated with CEP T2* (p = 0.0001) but not vertebral BMFF (p = 0.43). Conclusion Poor CEP composition plays a significant role in disc degeneration severity and can affect disc health both with and without deficits in vertebral perfusion. |
| Databáze: | OpenAIRE |
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