John T Martin1, Alexander B Oldweiler1, Andrzej S Kosinski2,3, Charles E Spritzer4, Brian J Soher4, Melissa M Erickson1, Adam P Goode1,2,5, Louis E DeFrate6,7,8,9. 1. Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, NC, USA. 2. Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC, USA. 3. Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC, USA. 4. Department of Radiology, Duke University School of Medicine, Durham, NC, USA. 5. Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA. 6. Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, NC, USA. lou.defrate@duke.edu. 7. Department of Biomedical Engineering, Duke University, Durham, NC, USA. lou.defrate@duke.edu. 8. Department of Mechanical Engineering and Materials Science, Duke University, Durham, NC, USA. lou.defrate@duke.edu. 9. Duke University Medical Center, Medical Sciences Research Building I, 203 Research Drive, Room 375, DUMC Box 3093, Durham, NC, 27710, USA. lou.defrate@duke.edu.
Abstract
PURPOSE: Magnetic resonance imaging (MRI) is routinely used to evaluate spine pathology; however, standard imaging findings weakly correlate to low back pain. Abnormal disc mechanical function is implicated as a cause of back pain but is not assessed using standard clinical MRI. Our objective was to utilize our established MRI protocol for measuring disc function to quantify disc mechanical function in a healthy cohort. METHODS: We recruited young, asymptomatic volunteers (6 male/6 female; age 18-30 years; BMI < 30) and used MRI to determine how diurnal deformations in disc height, volume, and perimeter were affected by spinal level, disc region, MRI biomarkers of disc health (T2, T1rho), and Pfirrmann grade. RESULTS: Lumbar discs deformed by a mean of -6.1% (95% CI: -7.6%, -4.7%) to -8.0% (CI: -10.6%, -5.4%) in height and -5.4% (CI: -7.6%, -3.3%) to -8.5% (CI: -11.0%, -6.0%) in volume from AM to PM across spinal levels. Regional deformations were more uniform in cranial lumbar levels and concentrated posteriorly in the caudal levels, reaching a maximum of 13.1% at L5-S1 (CI:-16.1%, -10.2%). T2 and T1rho relaxation times were greatest in the nucleus and varied circumferentially within the annulus. T2 relaxation times were greatest at the most cranial spinal levels and decreased caudally. In this young healthy cohort, we identified a weak association between nucleus T2 and the diurnal change in the perimeter. CONCLUSIONS: Spinal level is a key factor in determining regional disc deformations. Interestingly, deformations were concentrated in the posterior regions of caudal discs where disc herniation is most prevalent.
PURPOSE: Magnetic resonance imaging (MRI) is routinely used to evaluate spine pathology; however, standard imaging findings weakly correlate to low back pain. Abnormal disc mechanical function is implicated as a cause of back pain but is not assessed using standard clinical MRI. Our objective was to utilize our established MRI protocol for measuring disc function to quantify disc mechanical function in a healthy cohort. METHODS: We recruited young, asymptomatic volunteers (6 male/6 female; age 18-30 years; BMI < 30) and used MRI to determine how diurnal deformations in disc height, volume, and perimeter were affected by spinal level, disc region, MRI biomarkers of disc health (T2, T1rho), and Pfirrmann grade. RESULTS: Lumbar discs deformed by a mean of -6.1% (95% CI: -7.6%, -4.7%) to -8.0% (CI: -10.6%, -5.4%) in height and -5.4% (CI: -7.6%, -3.3%) to -8.5% (CI: -11.0%, -6.0%) in volume from AM to PM across spinal levels. Regional deformations were more uniform in cranial lumbar levels and concentrated posteriorly in the caudal levels, reaching a maximum of 13.1% at L5-S1 (CI:-16.1%, -10.2%). T2 and T1rho relaxation times were greatest in the nucleus and varied circumferentially within the annulus. T2 relaxation times were greatest at the most cranial spinal levels and decreased caudally. In this young healthy cohort, we identified a weak association between nucleus T2 and the diurnal change in the perimeter. CONCLUSIONS: Spinal level is a key factor in determining regional disc deformations. Interestingly, deformations were concentrated in the posterior regions of caudal discs where disc herniation is most prevalent.
Authors: Sarah E Gullbrand; Beth G Ashinsky; John T Martin; Stephen Pickup; Lachlan J Smith; Robert L Mauck; Harvey E Smith Journal: J Orthop Res Date: 2016-08-10 Impact factor: 3.494
Authors: Benjamin A Walter; Prasath Mageswaran; Xiaokui Mo; Daniel J Boulter; Hazem Mashaly; Xuan V Nguyen; Luciano M Prevedello; William Thoman; Brian D Raterman; Prateek Kalra; Ehud Mendel; William S Marras; Arunark Kolipaka Journal: Radiology Date: 2017-05-04 Impact factor: 11.105
Authors: John T Martin; Christopher M Collins; Kensuke Ikuta; Robert L Mauck; Dawn M Elliott; Yeija Zhang; D Greg Anderson; Alexander R Vaccaro; Todd J Albert; Vincent Arlet; Harvey E Smith Journal: J Orthop Res Date: 2014-10-01 Impact factor: 3.494
Authors: John T Martin; Alexander B Oldweiler; Charles E Spritzer; Brian J Soher; Melissa M Erickson; Adam P Goode; Louis E DeFrate Journal: J Biomech Date: 2018-02-09 Impact factor: 2.712
Authors: John T Martin; Benjamin Wesorick; Alexander B Oldweiler; Andrzej S Kosinski; Adam P Goode; Louis E DeFrate Journal: JOR Spine Date: 2022-04-23