Department of Biomedical Engineering, Duke University, Durham, NC, USA; Department of Orthopedic Surgery, Duke University School of Medicine, Durham, NC, USA.
Department of Orthopedic Surgery, Duke University School of Medicine, Durham, NC, USA.
Osteoarthritis Cartilage. 2023 Jan;31(1):126-133. doi: 10.1016/j.joca.2022.09.008. Epub 2022 Sep 30.
To assess the in vivo relationship between the mechanical response of intervertebral discs (IVDs) to dynamic activity and IVD biochemical composition assessed via T1rho relaxation imaging.
Eighteen asymptomatic participants with no history of low back pain (LBP), injury, or surgery underwent magnetic resonance (MR) imaging of their lumbar spine prior to and immediately following a treadmill walking "stress test." Anatomic (SPACE, FLASH) MR images were obtained pre- and post-exercise and utilized to measure IVD mechanical deformation. Quantitative (T1rho) imaging was performed pre-exercise to reflect IVD composition. Pre-exercise anatomic images were also utilized to assess IVD degenerative status based on the modified Pfirrmann scale. To quantify mechanical response, 3D surface models of the L1-L2-L5-S1 IVDs were created from manual segmentations of pre- and post-exercise anatomic images and utilized to assess changes in IVD height. IVD strain (%) was defined as change in IVD height normalized to pre-activity height. Linear mixed models were used to assess the relationships between IVD mechanical deformation (strain), composition (T1rho relaxation time), and degenerative status (Pfirrmann grade).
Increased compressive IVD strain was associated with lower T1rho relaxation times in the nucleus pulposus (NP) of the disc (β=5.07,CI:[1.52,7.77],R=0.52,p=0.005). Thus, an inverse relationship between IVD strain and NP T1rho relaxation time was observed.
The in vivo mechanical response of the IVD to the "stress test" was sensitive to differences in NP composition. The results of this study suggest that quantification of in vivo IVD mechanical function and composition may provide insight into IVD health.
评估通过 T1rho 弛豫成像评估的椎间盘 (IVD) 对动态活动的机械反应与 IVD 生化成分之间的体内关系。
18 名无症状参与者,无腰痛 (LBP)、损伤或手术史,在进行跑步机行走“应激试验”之前和之后立即接受腰椎磁共振 (MR) 成像。在运动前后获得解剖 (SPACE、FLASH) MR 图像,并用于测量 IVD 机械变形。进行定量 (T1rho) 成像以反映 IVD 成分。在运动前进行解剖图像,以根据改良 Pfirrmann 量表评估 IVD 退变状态。为了量化机械反应,从运动前后解剖图像的手动分割创建 L1-L2-L5-S1 IVD 的 3D 表面模型,并用于评估 IVD 高度的变化。IVD 应变(%)定义为 IVD 高度变化与活动前高度的归一化。线性混合模型用于评估 IVD 机械变形(应变)、组成(T1rho 弛豫时间)和退变状态(Pfirrmann 分级)之间的关系。
椎间盘 NP 中 IVD 压缩应变的增加与 NP T1rho 弛豫时间的降低相关(β=5.07,CI:[1.52,7.77],R=0.52,p=0.005)。因此,观察到 IVD 应变与 NP T1rho 弛豫时间之间的反比关系。
IVD 对“应激试验”的体内机械反应对 NP 成分的差异敏感。这项研究的结果表明,对 IVD 机械功能和组成的定量分析可能提供对 IVD 健康状况的深入了解。