Devoted to diagnostic and interventional spine imaging and therapeutics


Intervertebral Discs Regain And Maintain Height Adjacent To Insufficient Vertebral Compression Deformities 2013

Category General Spine Seong C. Oh, MD
Todd S. Miller, MD
Allan L. Brook, MD
Purpose To demonstrate that previously degenerated discs can regain height and maintain height gain over time. Materials & Methods 86 patients who had undergone vertebroplasty from our institution between 2005 and 2011 were retrospectively identified. Patients who had MR imaging of the spine more than 1 year after the time of their vertebral fracuture were then selected, some of whom had multiple fracture levels. Using a mid-sagittal T2 weighted image, the greatest craniocaudal dimension near or at the midpoint of each intervertebral disc was measured from L1 through S1, using T1 weighted images in equivocal cases. The disc levels at the time of patient's initial study were then compared with the patient's most recent MR study. Results 24 discs from 4 spines were included in the final analysis group. Patient's age ranged from 51 to 87 years old. The absoulte measurements of the lumbar intervertebral disc space height either maintained or increased in height more than a year since the patient's initial time of vertebral fracture in 18/24 disc spaces. Conclusion Increase or maintenance of disc height was seen in 18/24 disc levels of our analysis group. The gain in height was maintained for greater than one year after the patient's initial vertebral body fracture. The disc adjacent to an injured vertebral body expands to take space of the vertebral body height lost. A phenomenon is occuring in which vertebral body height is lost causing a change in hydrostatic pressure equilibrium between the disc and the insufficient bone. References 1. Taher F, Essig D, Lebl DR, Hughes AP, Sama AA, Cammisa FP, Girardi FP. Lumbar degenerative disc disease: current and future concepts of diagnosis and management. Adv Orthop. 2012;2012:970752. Epub 2012 Apr 2. 2. Pfirrmann CW, Metzdorf A, Zanetti M, Hodler J, Boos N.  Magnetic resonance classification of lumbar intervertebral disc degeneration. Spine (Phila Pa 1976). 2001 Sep 1;26(17):1873-8. 3. Modic MT, Masaryk TJ, Ross JS, Carter JR. Imaging of degenerative disk disease. Radiology. 1988 Jul;168(1):177-86. 4. Adams MA, Roughley PJ. What is intervertebral disc degeneration, and what causes it? Spine (Phila Pa 1976). 2006 Aug 15;31(18):2151-61. 5. Prologo JD, Pirasteh A, Tenley N, Yuan L, Corn D, Hart D, Love Z, Lazarus HM, Lee Z.Percutaneous Image-guided Delivery for the Transplantation of Mesenchymal stem cells in the setting of degenerated intervertebral discs. J Vasc Interv Radiol. 2012 Aug;23(8):1084-1088.e6. 6. Hohaus C, Ganey TM, Minkus Y, Meisel HJ. Cell transplantation in lumbar spine disc degeneration disease. Eur Spine J. 2008 Dec;17 Suppl 4:492-503. Epub 2008 Nov 13. 7. Sakai D, Mochida J, Iwashina T, Watanabe T, Nakai T, Ando K, Hotta T. Differentiation of mesenchymal stem cells transplanted to a rabbit degenerative disc model: potential and limitations for stem cell therapy in disc regeneration. Spine (Phila Pa 1976). 2005 Nov 1;30(21):2379-87. 8. Johannessen W, Auerbach JD, Wheaton AJ, Kurji A, Borthakur A, Reddy R, Elliott DM. Assessment of human disc degeneration  and proteoglycan content using T1rho-weighted magnetic resonance imaging. Spine (Phila Pa 1976). 2006 May 15;31(11):1253-7. 9. Wang C, Witschey W, Elliott MA, Borthakur A, Reddy R. Measurement of intervertebral disc pressure with T 1ρ MRI. Magn Reson Med. 2010 Dec;64(6):1721-7. 10. Carragee EJ, Don AS, Hurwitz EL, Cuellar JM, Carrino JA, Herzog R. 2009 ISSLS Prize Winner: Does discography cause  accelerated progression of degeneration changes in the lumbar disc: a ten-year matched cohort study. Spine (Phila Pa 1976). 2009 Oct 1;34(21):2338-45. 11. Zuo J, Joseph GB, Li X, Link TM, Hu SS, Berven SH, Kurhanewitz J, Majumdar S. In vivo intervertebral disc characterization  using magnetic resonance spectroscopy and T1ρ imaging: association with discography and Oswestry Disability Index and Short  Form-36 Health Survey.  Spine (Phila Pa 1976). 2012 Feb 1;37(3):214-21. 12. Urban JP, Roberts S.Degeneration of the intervertebral disc. Arthritis Res Ther. 2003;5(3):120-30. Epub 2003 Mar 11.