Universität zu Köln

Bostelmann, Richard ORCID: 0000-0002-0286-5724, Bostelmann, Tamara, Nasaca, Adrian, Steiger, Hans Jakob, Zaucke, Frank and Schleich, Christoph (2017). Biochemical validity of imaging techniques (X-ray, MRI, and dGEMRIC) in degenerative disc disease of the human cervical spine-an in vivo study. Spine Journal, 17 (2). S. 196 - 203. NEW YORK: ELSEVIER SCIENCE INC. ISSN 1878-1632

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Abstract

BACKGROUND CONTEXT: On a molecular level, maturation or degeneration of human intervertebral disc is among others expressed by the content of glycosaminoglycans (GAGs). According to the degenerative status, the disc content can differ in nucleus pulposus (NP) and annulus fibrosus (AF), respectively. Research in this area was conducted mostly on postmortem samples. Although several radiological classification systems exist, none includes biochemical features. Therefore, we focused our in vivo study on a widely spread and less expensive imaging technique for the cervical spine and the correlation of radiological patterns to biochemical equivalents in the intervertebral discs. PURPOSE: The aim of this pilot study was to (1) measure the GAG content in human cervical discs, (2) to investigate whether a topographic biochemical GAG pattern can be found, and (3) whether there is a correlation between imaging data (X-ray and magnetic resonance imaging [MRI] including delayed gadolinium-enhanced MRI of cartilage [dGEMRIC] as a special imaging technique of cartilage) and the biochemical data. STUDY DESIGN/SAMPLE: We conducted a prospective experimental pilot study. PATIENT SAMPLE: Only non-responders to conservative therapy were included. All subjects were physically and neurologically examined, and they completed their questionnaires. OUTCOME MEASURES: Visual analogue scale neck and arm, Neck Disability Index score, radiological parameters (X-rays, MRI, dGEMRIC), and the content of GAG in the cervical disc were assessed. METHODS: After surgical removal of 12 discs, 96 fractions of AF and NP were biochemically analyzed for the GAG content using dimethylmethylene blue assay. RESULTS: A quantitative pattern of GAGs in the human cervical disc was identified. There were (1) significantly (p<.001) higher values of GAGs (mu g GAG/mg tissue) in the NP (169.9 SD 37.3) compared with the AF (132.4 SD 42.2), and (2) significantly (p<.005) higher values of GAGs in the posterior (right/left: 149.9/160.2) compared with the anterior (right/left: 112.0/120.2) part of the AF. Third, we found in dGEMRIC imaging a significantly (p<.008) different distribution of GAGs in the cervical disc (NP 1083.3 ms [SD 248.6], AF 925.9 ms [SD 137.6]). Finally, we found that grading of disc degeneration in X-ray and MRI was significantly correlated with neither AF-nor NP-GAG content. CONCLUSIONS: The GAG content in human cervical discs can be detected in vivo and is subject to a significantly (p<.05) region-specific pattern (AF vs. NP; anterior vs. posterior in the AF). Up to the levels of AF and NP, this is reproducible in MRI in dGEMRIC technique, but not in X-ray or standard MRI sequences. Potentially, the MRI in dGEMRIC technique can be used as a non-invasive in vivo indicator for disc degeneration in the cervical spine. (C) 2016 Elsevier Inc. All rights reserved.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Bostelmann, Richard UNSPECIFIED orcid.org/0000-0002-0286-5724 UNSPECIFIED Bostelmann, Tamara UNSPECIFIED UNSPECIFIED UNSPECIFIED Nasaca, Adrian UNSPECIFIED UNSPECIFIED UNSPECIFIED Steiger, Hans Jakob UNSPECIFIED UNSPECIFIED UNSPECIFIED Zaucke, Frank UNSPECIFIED UNSPECIFIED UNSPECIFIED Schleich, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-240873
DOI:	10.1016/j.spinee.2016.08.031
Journal or Publication Title:	Spine Journal
Volume:	17
Number:	2
Page Range:	S. 196 - 203
Date:	2017
Publisher:	ELSEVIER SCIENCE INC
Place of Publication:	NEW YORK
ISSN:	1878-1632
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language AGE-RELATED-CHANGES; HUMAN INTERVERTEBRAL DISC; EXTRACELLULAR-MATRIX; NUCLEUS PULPOSUS; GRADING SYSTEM; MORPHOLOGY; GLYCOSAMINOGLYCANS; CARTILAGE; FIBROSUS Multiple languages Clinical Neurology; Orthopedics Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/24087