Department of Spine Surgery, Ganzhou People's Hospital, Ganzhou, Jiangxi, 341000, China.
Department of Spine Surgery, Ganzhou Hospital, Jiangxi Medical College, Nanchang University, Ganzhou, Jiangxi, 341000, China.
BMC Musculoskelet Disord. 2024 Mar 20;25(1):224. doi: 10.1186/s12891-024-07265-9.
To investigate the biochemical changes in lumbar facet joint (LFJ) and intervertebral disc (IVD) with different degenerative grade by T2* mapping.
Sixty-eight patients with low back pain (study group) and 20 volunteers (control group) underwent standard MRI protocols and axial T2* mapping. Morphological evaluation of LFJ and IVD were performed on T2-weighted imaging according to Weishaupt and Pfirrmann grading system, respectively. T2* values of LFJ and of AF (anterior annulus fibrosus), NP (nucleus pulposus), and PF (posterior annulus fibrosus) in IVD were measured. Kruskal-Wallis test and Wilcoxon rank-sum test were used to compare T2* values of subjects with different degenerative grade.
The mean T2* value of grade 0 LFJ (21.68[17.77,26.13]) was higher than those of grade I (18.42[15.68,21.8], p < 0.001), grade II (18.98[15.56,22.76], p = 0.011) and grade III (18.38[16.05,25.07], p = 0.575) LFJ in study group, and a moderate correlation was observed between T2* value and LFJ grade (rho=-0.304, p < 0.001) in control group. In the analysis of IVD, a moderate correlation was observed between AF T2* value and IVD grade (rho=-0.323, p < 0.001), and between NP T2* value and IVD grade (rho=-0.328, p < 0.001), while no significant difference was observed between the T2* values of PF in IVD of different grade in study group.
Downward trend of T2* values can be found in LFJ, AF and NP as the degenerative grade rised. But in elderly patients with low back pain, no change trend was found in LFJ due to increased fluid accumulation in the joint space.
通过 T2* 映射研究不同退变程度腰椎小关节(LFJ)和椎间盘(IVD)的生化变化。
68 例腰痛患者(研究组)和 20 名志愿者(对照组)接受标准 MRI 方案和轴向 T2* 映射。根据 Weishaupt 和 Pfirrmann 分级系统分别对 LFJ 和 IVD 的 T2 加权成像进行形态学评估。测量 LFJ 的 T2* 值和 IVD 中 AF(前纤维环)、NP(髓核)和 PF(后纤维环)的 T2* 值。采用 Kruskal-Wallis 检验和 Wilcoxon 秩和检验比较不同退变程度患者的 T2* 值。
研究组 0 级 LFJ(21.68[17.77,26.13])的平均 T2* 值高于 1 级(18.42[15.68,21.8],p<0.001)、2 级(18.98[15.56,22.76],p=0.011)和 3 级(18.38[16.05,25.07],p=0.575)LFJ,对照组 T2* 值与 LFJ 分级呈中度相关(rho=-0.304,p<0.001)。在 IVD 分析中,AF T2* 值与 IVD 分级呈中度相关(rho=-0.323,p<0.001),NP T2* 值与 IVD 分级呈中度相关(rho=-0.328,p<0.001),但研究组不同分级 IVD 中 PF 的 T2* 值无显著差异。
随着退变程度的增加,LFJ、AF 和 NP 的 T2* 值呈下降趋势。但在老年腰痛患者中,由于关节腔内液体积累增加,LFJ 无变化趋势。