scholarly journals The contributions of cartilage endplate composition and vertebral bone marrow fat to intervertebral disc degeneration in patients with chronic low back pain

Author(s):  
Noah B Bonnheim ◽  
Linshanshan Wang ◽  
Anne A Lazar ◽  
Jiamin Zhou ◽  
Ravi Chachad ◽  
...  

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 may play a significant role in disc degeneration severity and can affect disc health both with and without deficits in vertebral perfusion.

2020 ◽  
Vol 49 (11) ◽  
pp. 1753-1763
Author(s):  
Yayun Ji ◽  
Weifeng Hong ◽  
Mouyuan Liu ◽  
Yuying Liang ◽  
YongYan Deng ◽  
...  

Abstract Objective To investigate the potential clinical application of quantitative MRI in assessing the correlation between lumbar vertebrae bone marrow fat deposition and intervertebral disc degeneration. Materials and methods A total of 104 chronic lower-back pain volunteers underwent 3.0-T MRI with T2-weighted imaging, T2 mapping, and iterative decomposition of water and fat with echo asymmetry and least squares estimation (IDEAL-IQ) between August 2018 and June 2019. Each disc was assessed with T2 value by T2 mapping, and the L1-S1 vertebral bone marrow fat fraction was assessed by IDEAL-IQ. The differences and relationship between T2 value and the adjacent vertebral bone marrow fat fraction values within the five Pfirrmann groups, five age groups, and five lumbar levels were statistically analyzed. Results The vertebral bone marrow fat fraction had a significant negative correlation with T2 values of nucleus pulposus’ T2 values (p < 0.001). However, the significant negative correlation was only found between T2 values of nucleus pulposus and adjacent vertebral bone marrow fat in Pfirrmann II–III, L1/2-L5/S1 level, and 40–49 years’ age groups. Pfirrmann grades of the intervertebral disc were positively correlated with adjacent vertebrae bone marrow fat fraction (p < 0.05). Conclusion Lumbar bone marrow fat deposition significantly increases during the early stages of intervertebral disc degeneration. Quantitative measurements of bone marrow fat deposition and water content of intervertebral discs have a predictive value and are an important supplement to the qualitative traditional classification strategies for the early stages of intervertebral disc degeneration.


2015 ◽  
Vol 28 (4) ◽  
pp. 432-439 ◽  
Author(s):  
Michael Dieckmeyer ◽  
Stefan Ruschke ◽  
Christian Cordes ◽  
Samuel P. Yap ◽  
Hendrik Kooijman ◽  
...  

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Michael Dieckmeyer ◽  
Stefan Ruschke ◽  
Alexander Rohrmeier ◽  
Jan Syväri ◽  
Ingo Einspieler ◽  
...  

Abstract Background Quantification of vertebral bone marrow (VBM) water–fat composition has been proposed as advanced imaging biomarker for osteoporosis. Estrogen deficiency is the primary reason for trabecular bone loss in postmenopausal women. By reducing estrogen levels aromatase inhibitors (AI) as part of breast cancer therapy promote bone loss. Bisphosphonates (BP) are recommended to counteract this adverse drug effect. The purpose of our study was to quantify VBM proton density fat fraction (PDFF) changes at the lumbar spine using chemical shift encoding-based water-fat MRI (CSE-MRI) and bone mineral density (BMD) changes using dual energy X-ray absorptiometry (DXA) related to AI and BP treatment over a 12-month period. Methods Twenty seven postmenopausal breast cancer patients receiving AI therapy were recruited for this study. 22 subjects completed the 12-month study. 14 subjects received AI and BP (AI+BP), 8 subjects received AI without BP (AI-BP). All subjects underwent 3 T MRI. An eight-echo 3D spoiled gradient-echo sequence was used for CSE-based water-fat separation at the lumbar spine to generate PDFF maps. After manual segmentation of the vertebral bodies L1-L5 PDFF values were extracted for each vertebra and averaged for each subject. All subjects underwent DXA of the lumbar spine measuring the average BMD of L1-L4. Results Baseline age, PDFF and BMD showed no significant difference between the two groups (p > 0.05). There was a relative longitudinal increase in mean PDFF (∆relPDFF) in both groups (AI+BP: 5.93%; AI-BP: 3.11%) which was only significant (p = 0.006) in the AI+BP group. ∆relPDFF showed no significant difference between the two groups (p > 0.05). There was no significant longitudinal change in BMD (p > 0.05). Conclusions Over a 12-month period, VBM PDFF assessed with CSE-MRI significantly increased in subjects receiving AI and BP. The present results contradict previous results regarding the effect of only BP therapy on bone marrow fat content quantified by magnetic resonance spectroscopy and bone biopsies. Future longer-term follow-up studies are needed to further characterize the effects of combined AI and BP therapy.


Bone ◽  
2018 ◽  
Vol 108 ◽  
pp. 20-24 ◽  
Author(s):  
Swaroop D. Mistry ◽  
Gina N. Woods ◽  
Sigurdur Sigurdsson ◽  
Susan K. Ewing ◽  
Trisha F. Hue ◽  
...  

Bone ◽  
2014 ◽  
Vol 61 ◽  
pp. 33-38 ◽  
Author(s):  
Ville Huovinen ◽  
Virva Saunavaara ◽  
Riku Kiviranta ◽  
Miikka Tarkia ◽  
Henri Honka ◽  
...  

2015 ◽  
Vol 42 (4) ◽  
pp. 1018-1023 ◽  
Author(s):  
Thomas Baum ◽  
Samuel P. Yap ◽  
Michael Dieckmeyer ◽  
Stefan Ruschke ◽  
Holger Eggers ◽  
...  

2013 ◽  
Vol 98 (6) ◽  
pp. 2294-2300 ◽  
Author(s):  
Ann V. Schwartz ◽  
Sigurdur Sigurdsson ◽  
Trisha F. Hue ◽  
Thomas F. Lang ◽  
Tamara B. Harris ◽  
...  

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