Glycosaminoglycan chemical exchange saturation transfer in human lumbar intervertebral discs: Effect of saturation pulse and relationship with low back pain

2016 ◽  
Vol 45 (3) ◽  
pp. 863-871 ◽  
Author(s):  
Tatsuhiro Wada ◽  
Osamu Togao ◽  
Chiaki Tokunaga ◽  
Ryohei Funatsu ◽  
Yasuo Yamashita ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Chemical Exchange ◽  
Intervertebral Discs ◽  
Chemical Exchange Saturation Transfer ◽  
Low Back ◽  
Saturation Transfer ◽  
Saturation Pulse

scholarly journals Intradiscal quantitative chemical exchange saturation transfer MRI signal correlates with discogenic pain in human patients

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Gadi Pelled ◽  
Margaux M. Salas ◽  
Pei Han ◽  
Howard E. Gill ◽  
Karl A. Lautenschlager ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Chemical Exchange ◽  
Invasive Procedure ◽  
Chemical Exchange Saturation Transfer ◽  
Low Back ◽  
Saturation Transfer ◽  
Operating Characteristics ◽  
Discogenic Pain ◽  
Quantitative Chemical

AbstractLow back pain (LBP) is often a result of a degenerative process in the intervertebral disc. The precise origin of discogenic pain is diagnosed by the invasive procedure of provocative discography (PD). Previously, we developed quantitative chemical exchange saturation transfer (qCEST) magnetic resonance imaging (MRI) to detect pH as a biomarker for discogenic pain. Based on these findings we initiated a clinical study with the goal to evaluate the correlation between qCEST values and PD results in LBP patients. Twenty five volunteers with chronic low back pain were subjected to T2-weighted (T2w) and qCEST MRI scans followed by PD. A total of 72 discs were analyzed. The average qCEST signal value of painful discs was significantly higher than non-painful discs (p = 0.012). The ratio between qCEST and normalized T2w was found to be significantly higher in painful discs compared to non-painful discs (p = 0.0022). A receiver operating characteristics (ROC) analysis indicated that qCEST/T2w ratio could be used to differentiate between painful and non-painful discs with 78% sensitivity and 81% specificity. The results of the study suggest that qCEST could be used for the diagnosis of discogenic pain, in conjunction with the commonly used T2w scan.

scholarly journals Non-Specific Low Back Pain and Lumbar Radiculopathy: Comparison of Morphologic and Compositional MRI as Assessed by gagCEST Imaging at 3T

Diagnostics ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 402
Author(s):  
Miriam Frenken ◽  
Sven Nebelung ◽  
Christoph Schleich ◽  
Anja Müller-Lutz ◽  
Karl Ludger Radke ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Chemical Exchange ◽  
Clinical Pathology ◽  
Chemical Exchange Saturation Transfer ◽  
Low Back ◽  
Intervertebral Disks ◽  
Asymptomatic Volunteers

Using glycosaminoglycan Chemical Exchange Saturation Transfer (gagCEST) magnetic resonance imaging (MRI), this study comparatively evaluated the GAG contents of lumbar intervertebral disks (IVDs) of patients with non-specific low back pain (nsLBP), radiculopathy, and asymptomatic volunteers to elucidate the association of clinical manifestation and compositional correlate. A total of 18 patients (mean age 57.5 ± 22.5 years) with radiculopathy, 16 age-matched patients with chronic nsLBP and 20 age-matched volunteers underwent standard morphologic and compositional gagCEST MRI on a 3T scanner. In all cohorts, GAG contents of lumbar IVDs were determined using gagCEST MRI. An assessment of morphologic IVD degeneration based on the Pfirrmann classification and T2-weighted sequences served as a reference. A linear mixed model adjusted for multiple confounders was used for statistical evaluation. IVDs of patients with nsLBP showed lower gagCEST values than those of volunteers (nsLBP: 1.3% [99% confidence intervals (CI): 1.0; 1.6] vs. volunteers: 1.9% [99% CI: 1.6; 2.2]). Yet, IVDs of patients with radiculopathy (1.8% [99% CI: 1.4; 2.1]) were not different from patients with nsLBP or volunteers. In patients with radiculopathy, IVDs directly adjacent to IVD extrusions demonstrated lower gagCEST values than distant IVDs (adjacent: 0.9% [99% CI: 0.3; 1.5], distant: 2.1% [99% CI: 1.7; 2.5]). Advanced GAG depletion in nsLBP and directly adjacent to IVD extrusions in radiculopathy indicates close interrelatedness of clinical pathology and compositional degeneration.

scholarly journals Low Back Pain: The Potential Contribution of Supraspinal Motor Control and Proprioception

2018 ◽  
Vol 25 (6) ◽  
pp. 583-596 ◽  
Author(s):  
Michael Lukas Meier ◽  
Andrea Vrana ◽  
Petra Schweinhardt
Keyword(s):  
Low Back Pain ◽  
Motor Control ◽  
Back Pain ◽  
Control Strategies ◽  
Intervertebral Discs ◽  
Cortical Reorganization ◽  
Potential Contribution ◽  
Low Back ◽  
Output Side

Motor control, which relies on constant communication between motor and sensory systems, is crucial for spine posture, stability and movement. Adaptions of motor control occur in low back pain (LBP) while different motor adaption strategies exist across individuals, probably to reduce LBP and risk of injury. However, in some individuals with LBP, adapted motor control strategies might have long-term consequences, such as increased spinal loading that has been linked with degeneration of intervertebral discs and other tissues, potentially maintaining recurrent or chronic LBP. Factors contributing to motor control adaptations in LBP have been extensively studied on the motor output side, but less attention has been paid to changes in sensory input, specifically proprioception. Furthermore, motor cortex reorganization has been linked with chronic and recurrent LBP, but underlying factors are poorly understood. Here, we review current research on behavioral and neural effects of motor control adaptions in LBP. We conclude that back pain-induced disrupted or reduced proprioceptive signaling likely plays a pivotal role in driving long-term changes in the top-down control of the motor system via motor and sensory cortical reorganization. In the outlook of this review, we explore whether motor control adaptations are also important for other (musculoskeletal) pain conditions.

Low back pain – literature review

Ból ◽  
2020 ◽  
Vol 20 (3) ◽  
pp. 51-59
Author(s):  
Marcin Kopka
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Intervertebral Discs ◽  
Prior History ◽  
Low Back ◽  
Red Flags ◽  
Recurrence Rates ◽  
Reduction Of Pain ◽  
History Of ◽  
Optimal Visualization

Low back pain (LBP) is the third most common disorder presenting in the neurology outpatient clinic. It is usually defined as acute (less than 4 weeks), subacute (4–8 weeks) and chronic (more than 12 weeks). It is estimated that lifetime prevalence of up to 84 %. LBP is the most common cause of disability. LBP is divided into musculoskeletal and neurologic low back pain. In 90% of patients under the age of 65 the cause of pain is nerve root compression caused by disk herniation. Although serious spinal pathology is rare (less than 1%), the identification of red flags remains key in the evaluation of patients with LBP. A prior history of cancer, even in the absence of other red flags, has the highest predictive value for detection of malignancy. In conjunction with the history, a careful neurologic examination can help establish the presence and localize the lesion. According to guidelines imaging studies should not be obtained in patients with LBP of less than 6 weeks duration in the absence of red flags. Magnetic resonance imaging is the study of choice in patients with LBP. It allows for optimal visualization of the spinal cord, nerve roots and intervertebral discs. The results of MRI should be interpreted with caution because incidental degenerative spine changes unrelated to the pain are commonly seen in MRI. The main goals of treatment the patients presenting with acute LBP are reduction of pain and preservation of sensory and motor function. In the absence of red flags, for most cases conservative management will be appropriate. Prognosis are favorable, although recurrence rates range from 23% to 80%.

scholarly journals Discogenic low back pain: interventional treatment

Pain medicine ◽  
2018 ◽  
Vol 3 (3) ◽  
pp. 16-26
Author(s):  
V I Smolanka ◽  
V M Fedurtsya ◽  
B B Pavlov
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Adult Population ◽  
Intervertebral Discs ◽  
Interventional Treatment ◽  
Therapeutic Effects ◽  
Low Back ◽  
Discogenic Pain ◽  
Discogenic Low Back Pain ◽  
Common Causes

Low back pain (LBP) is one of the most common causes of disability in the adult population. A significant place in its genesis is occupied by a degenerative-dystrophic diseases of intervertebral discs. The article highlights the classification and mechanism of discogenic pain origin. Various types of interventions aredescribed for this pathology: indications, specificities of carrying out manipulations and therapeutic effects, efficiency and possible complications of procedures.

DIAGNOSTIC RADIOLOGY METHODS OF DEGENERATIVE CHANGES IN LUMBAR INTERVERTEBRAL DISCS IN YOUNG PEOPLE

2020 ◽  
pp. 93-96
Author(s):  
Ilhar Halyb ohly Mammadov
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Clinical Symptoms ◽  
Intervertebral Discs ◽  
Information Value ◽  
Diagnostic Radiology ◽  
Degenerative Changes ◽  
Low Back ◽  
Disc Disease ◽  
Disc Protrusion

In recent years, the number of scientific studies investigating the prevalence of low back pain among schoolchildren has been significantly increased. Degenerative disease of the discs is often accompanied by a low back pain with irradiation into the legs in representatives of different age groups, in particular, in older children. The main factors of its development are genetic predisposition, trauma, obesity, lack of exercise. Most of the components of the vertebral motor segment have the nerve endings and reflex influences, accompanied by inflammation, microcirculatory disorders, and their combination contributes to an appearance of back pain. Diagnosis of degenerative disc disease includes the study of the patient's medical history, analysis of clinical symptoms, use of functional tests and various types of imaging to clarify the degree of macrostructural changes in disks, among which the main place is taken by the magnetic resonance imaging. The development of degenerative changes in intervertebral discs as early as childhood, which requires a further study using non−invasive, accessible and informative methods, especially ultrasound ones. The results of ultrasonography of lumbar intervertebral discs were analyzed in 36 adolescents aged 16−18 years, diagnosed for the protrusion when the MRI was applied. Paramedian protrusion was found to be significantly more frequent than posterolateral, median, and circular ones. Due to its non−invasiveness, low price and information value, the ultrasound can be the most popular method not only as a screening one but also for the expert evaluation of lumbar intervertebral disc protrusion in schoolchildren. Key words: diagnostic radiology, lumbar intervertebral discs, adolescents.

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