Kawchuk G N, Kaigle A M, Holm S H, Rod Fauvel O, Ekström L, Hansson T
Department of Orthopaedics, Sahlgrenska University Hospital, Göteborg, Sweden.
Spine (Phila Pa 1976). 2001 Jun 15;26(12):1348-55. doi: 10.1097/00007632-200106150-00018.
The diagnostic performance of a newly described variable was assessed in an in vivo model of disc degeneration using a split-pair experimental design.
To determine if vertebral displacement measures generated from ultrasonic indentation could distinguish between experimental and control groups of animals.
Few procedures are available that noninvasively assess subcutaneous vertebral mechanics. Information from such a procedure would be of value in determining potential clinical relevance of spinal mechanics with respect to low back pain.
Eight adolescent pigs underwent endplate perforation surgery to initiate lumbar disc degeneration. After 4 months of recovery, these and eight age-matched controls were assessed by ultrasonic indentation, a noninvasive procedure that quantifies vertebral displacements in the plane of loading-indentation. Each animal then received a facetectomy and was reindented at the same location as confirmed by ultrasonic imaging. Discal materials were removed postmortem for analysis.
Degenerative discs exhibited morphologic changes consistent with early degenerative disc disease. Prefacetectomy comparison of vertebral displacement measures between control and experimental animals resulted in sensitivity, specificity, and diagnostic accuracy values of 75.0%, 83.3%, and 77%, respectively. After facetectomy these values increased to 87.5%, 83.3%, and 85%, respectively. These measures of diagnostic performance were comparable or superior to those of existing clinical techniques (invasive or otherwise) used to assess degenerative conditions of the spine.
The results of this study suggest that noninvasive measures of vertebral displacement are clinically significant and possess the additional advantages of being objective and noninvasive.
采用裂对实验设计，在椎间盘退变的体内模型中评估一种新描述变量的诊断性能。
确定超声压痕产生的椎体位移测量值能否区分实验组和对照组动物。
很少有程序可用于非侵入性评估皮下椎体力学。来自这样一种程序的信息对于确定脊柱力学与腰痛的潜在临床相关性具有价值。
八只青春期猪接受终板穿孔手术以引发腰椎间盘退变。恢复4个月后，通过超声压痕对这些猪和八只年龄匹配的对照猪进行评估，超声压痕是一种非侵入性程序，可量化加载压痕平面内的椎体位移。然后对每只动物进行小关节切除术，并在超声成像确认的相同位置再次进行压痕测量。死后取出椎间盘材料进行分析。
退变椎间盘表现出与早期退变椎间盘疾病一致的形态学变化。小关节切除术前，对照组和实验组动物之间椎体位移测量值的敏感性、特异性和诊断准确性分别为75.0%、83.3%和77%。小关节切除术后，这些值分别增加到87.5%、83.3%和85%。这些诊断性能指标与用于评估脊柱退变情况的现有临床技术（有创或无创）相当或更优。
本研究结果表明，椎体位移的非侵入性测量具有临床意义，并且具有客观和非侵入性的额外优势。
