Effect of aging and degeneration on disc volume and shape: A quantitative study in asymptomatic volunteers

Pfirrmann, Christian W. A.; Metzdorf, Alexander; Elfering, Achim; Hodler, Juerg; Boos, Norbert

doi:10.1002/jor.20113

Cited by 128 publications

(117 citation statements)

References 34 publications

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“…Association between intervertebral disc degeneration and DS remained controversial. Decreased intervertebral disc height, or narrowing was usually considered as a degenerative indicator [7,19]. Some studies indicated that intervertebral disc narrowing had no significant relationship with DS [5,20].…”

Section: Discussionmentioning

confidence: 99%

Motion characteristics of the vertebral segments with lumbar degenerative spondylolisthesis in elderly patients

et al. 2012

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Objective Although some studies have reported on the kinematics of the lumbar segments with degenerative spondylolisthesis (DS), few data have been reported on the in vivo 6 degree-of-freedom kinematics of different anatomical structures of the diseased levels under physiological loading conditions. This research is to study the in vivo motion characteristics of the lumbar vertebral segments with L4 DS during weight-bearing activities. Methods Nine asymptomatic volunteers (mean age 54.4) and 9 patients with L4 DS (mean age 73.4) were included. Vertebral kinematics was obtained using a combined MRI/ CT and dual fluoroscopic imaging technique. During functional postures (supine, standing upright, flexion, and extension), disc heights, vertebral motion patterns and instability were compared between the two groups.Results Although anterior disc heights were smaller in the DS group than in the normal group, the differences were only significant at standing upright. Posterior disc heights were significantly smaller in DS group than in the normal group under all postures. Different vertebral motion patterns were observed in the DS group, especially in the left-right and cranial-caudal directions during flexion and extension of the body. However, the range of motions of the both groups were much less than the reported criteria of lumbar spinal instability. Conclusion The study showed that lumbar vertebra with DS has disordered motion patterns. DS did not necessary result in vertebral instability. A restabilization process may have occurred and surgical treatment should be planned accordingly.

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Section: Discussionmentioning

confidence: 99%

Motion characteristics of the vertebral segments with lumbar degenerative spondylolisthesis in elderly patients

et al. 2012

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“…1 were measured in a healthy cadaveric lumbar disc (Grade = 2.3) [25]. T1 was measured at both 7T and 3T magnetic field strength using a fully relaxed (TR = 5,100 ms) 2D spin echo inversion recovery pulse sequence with ten different inversion times (TI = 33-5,000 ms, TE = 11/13 ms (7T and 3T, respectively), in-plane resolution = 200 9 200 lm 2 , slice thickness = 5 mm, matrix = 256 9 256, and field of view = 5.1 9 5.1 cm 2 , Receiver Bandwidth (RBW) = 200 Hz/Px).…”

Section: Optimization Of Cep Image Contrastmentioning

confidence: 99%

“…While for some subjects 2-3 levels were used from a single spine, consistent with common practice in the literature [32][33][34], these discs were assumed to be independent samples and post hoc statistical analysis confirmed no subject dependence on CEP height. Each whole spine was first scanned with a mid-sagittal T2-weighted turbo spin echo imaging sequence for routine grading of degenerative state [25,26]. The integer grade from five individual examiners was averaged (Grade: 2.8 ± 0.7).…”

Section: Optimization Of Cep Image Contrastmentioning

confidence: 99%

“…Magnetic resonance imaging (MRI) is a non-invasive, non-ionizing imaging modality well known for its superior soft tissue contrast, making it ideal for disc applications including anatomy, composition, and stage of degeneration through a number techniques (e.g., T1q-and T2-weighted images) [23][24][25][26][27]. Application of MRI to the study of disc degeneration has to date focused predominantly on the NP and annulus fibrosus, with few studies examining the CEP.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of intervertebral disc cartilaginous endplate structure using magnetic resonance imaging

et al. 2013

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Purpose The cartilaginous endplate (CEP) is a thin layer of hyaline cartilage positioned between the vertebral endplate and nucleus pulposus (NP) that functions both as a mechanical barrier and as a gateway for nutrient transport into the disc. Despite its critical role in disc nutrition and degeneration, the morphology of the CEP has not been well characterized. The objective of this study was to visualize and report observations of the CEP three-dimensional morphology, and quantify CEP thickness using an MRI FLASH (fast low-angle shot) pulse sequence. Methods MR imaging of ex vivo human cadaveric lumbar spine segments (N = 17) was performed in a 7T MRI scanner with sequence parameters that were selected by utilizing highresolution T1 mapping, and an analytical MRI signal model to optimize image contrast between CEP and NP. The CEP thickness at five locations along the mid-sagittal AP direction (center, 5 mm, 10 mm off-center towards anterior and posterior) was measured, and analyzed using two-way ANOVA and a post hoc Bonferonni test. For further investigation, six in vivo volunteers were imaged with a similar sequence in a 3T MRI scanner. In addition, decalcified and undecalcified histology was performed, which confirmed that the FLASH sequence successfully detected the CEP. Results CEP thickness determined by MRI in the midsagittal plane across all lumbar disc levels and locations was 0.77 ± 0.24 mm ex vivo. The CEP thickness was not different across disc levels, but was thinner toward the center of the disc. Conclusions This study demonstrates the potential of MRI FLASH imaging for structural quantification of the CEP geometry, which may be developed as a technique to evaluate changes in the CEP with disc degeneration in future applications.

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“…Many different small [39,48,60] and large animal models [27,37,44] have been described and reviewed in great detail [2,32], though no animal is identical to the human situation and each model has individual advantages and disadvantages, which should be carefully considered. The use of the minipig model is attractive because porcine spines are close to human anatomy, IVDs are almost as large as human discs [15,35,44,45,54] and it allows to test if the transplanted cells can survive in this relatively large biologic structure without vascular supply.…”

Section: Introductionmentioning

confidence: 99%

Methods to monitor distribution and metabolic activity of mesenchymal stem cells following in vivo injection into nucleotomized porcine intervertebral discs

et al. 2009

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Intervertebral disc (IVD) degeneration involves a series of biochemical and morphological changes leading to loss of spinal stability and flexibility. Cell therapy is promising to reconstitute IVDs with new cells, however, sustained metabolic activity seems crucial for an active contribution to regeneration. The aim of the present study was to establish methods for separate follow up of persistence and activity of autologous porcine mesenchymal stem cells (pMSC) after implantation into IVDs of Goettingen minipigs in vivo in order to conclude about the potential of such an intervention strategy. For quantitative follow up, the transfer matrix was supplemented with Al 2 O 3 particles and pMSC which were retrovirally labeled with firefly luciferase (pMSC-Luc). Six mature Goettingen minipigs underwent matrix based cell transfer after partial nucleotomy of lumbar IVDs (n = 24). Day 0 and day 3 segments were analyzed for retained volume of Al 2 O 3 particles by micro-computed-tomography (lCT) and for cell activity by luciferase enzyme assessment. Three days after injection a reduction of Al 2 O 3 particles (P = 0.028) to about 9% and of pMSC-Luc activity to about 7% of initial values (P = 0.003) was detected, which suggests loss of 90% of the implant material under in vivo conditions without evidence for reduced pMSC-Luc metabolic activity (P = 0.887). In conclusion, separate follow up of implant material and cell activity was possible and unravels problems with in vivo implant persistence after annular puncture rather than quick loss of cell activity. Therefore, IVD-regeneration-strategies should increasingly focus on annulus reconstruction in order to reduce implant loss due to annular failure.

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Effect of aging and degeneration on disc volume and shape: A quantitative study in asymptomatic volunteers

Cited by 128 publications

References 34 publications

Motion characteristics of the vertebral segments with lumbar degenerative spondylolisthesis in elderly patients

Motion characteristics of the vertebral segments with lumbar degenerative spondylolisthesis in elderly patients

Evaluation of intervertebral disc cartilaginous endplate structure using magnetic resonance imaging

Methods to monitor distribution and metabolic activity of mesenchymal stem cells following in vivo injection into nucleotomized porcine intervertebral discs

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