Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, 2-50 Corbett Hall, Edmonton, AB, CA T6G 2G4, Canada.
Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, 3-48 Corbett Hall, Edmonton, AB, CA T6G 2G4, Canada.
Musculoskelet Sci Pract. 2020 Dec;50:102250. doi: 10.1016/j.msksp.2020.102250. Epub 2020 Sep 3.
Diagnostic imaging is routinely used to depict structural abnormalities in people with low back pain (LBP), but most findings are prevalent in people with and without LBP. It has been suggested that LBP is related to changes induced in the spine due to loading. Therefore, new imaging measurements are needed to improve our ability to identify structures relating to LBP.
To investigate the response of the lumbar spine to compression and traction in participants with and without chronic LBP using MRI T-mapping.
Fifteen participants with chronic LBP were matched for age, weight, and gender with 15 healthy volunteers. All participants underwent MRI under three loading conditions maintained for 20 min each: resting supine, followed by compression and traction, both using 50% body weight. Participants were imaged in the last 5 min of each loading condition. Disc morphometric and fluid-based measurements from T-maps were obtained.
Traditional MRI measurements (i.e. disc height, width and mean signal intensity) were not able to capture any differences in the changes measured in response to loading between individuals with and without pain. The location of the T weighted centroid (WC) was able to capture the difference between groups in response to compression in the horizontal (p < 0.01) and vertical direction (p < 0.01), and in response to traction in the vertical direction (p < 0.01). While the location of TWC moved anteriorly (Effect Size (ES): 0.44) and inferiorly with compression in those with pain (ES: 0.34), it moved posteriorly (ES: -0.14) and superiorly (ES: -0.05) in the group without pain. In response to traction, the vertical location of TWC moved superiorly in both groups but the change was larger in those with pain (ES = -0.52; ES : -0.13).
The novel measurements of the location of the TWC in the intervertebral discs were the only measurements capturing differences in response to loading between those with and without low back pain.
诊断成像通常用于描绘腰痛（LBP）患者的结构异常，但大多数发现普遍存在于有和没有 LBP 的患者中。有人认为，LBP 与脊柱因负荷而产生的变化有关。因此，需要新的成像测量方法来提高我们识别与 LBP 相关结构的能力。
使用 MRI T 映射技术研究慢性 LBP 患者和无慢性 LBP 患者的腰椎对压缩和牵引的反应。
将 15 名慢性 LBP 患者与 15 名健康志愿者按年龄、体重和性别匹配。所有参与者在三种加载条件下接受 MRI 检查，每种条件持续 20 分钟：仰卧休息，然后是压缩和牵引，均使用 50%体重。参与者在每个加载条件的最后 5 分钟进行成像。从 T 映射中获得椎间盘形态学和基于流体的测量值。
传统的 MRI 测量值（即椎间盘高度、宽度和平均信号强度）无法捕捉到有疼痛和无疼痛个体对加载反应的差异。T 加权质心（WC）的位置能够捕捉到在水平（p<0.01）和垂直方向（p<0.01）对压缩以及在垂直方向对牵引的反应中组间的差异（p<0.01）。当 WC 在有疼痛的患者中因压缩而向前（效应量（ES）：0.44）和向下移动时（ES：0.34），它在无疼痛的患者中向后（ES：-0.14）和向上（ES：-0.05）移动。在牵引反应中，TWC 的垂直位置在两组中均向上移动，但疼痛组的变化更大（ES=-0.52；ES=-0.13）。
椎间盘 TWC 位置的新测量值是唯一能够捕捉到有和无腰痛患者对加载反应差异的测量值。
