Abstract
Lumbar intervertebral disc (IVD) degeneration is characterized by structural and compositional changes. This study aimed to assess the glycosaminoglycan (GAG) content of IVDs of patients with adolescent idiopathic scoliosis (AIS) and healthy controls using GAG chemical exchange saturation transfer (gagCEST) imaging. Ten AIS patients (mean age 18.3 ± 8.2 years) and 16 healthy controls (mean age 25.5 ± 1.7 years) were included. Clinical standard morphologic MR images (T1w-, T2w-, and STIR-sequences), to rule out further spinal disorders and assess IVD degeneration using the Pfirrmann score, and compositional gagCEST sequences were acquired on a 3T MRI. In AIS patients, the most distal scoliotic curve was determined on whole-spine conventional radiographs and morphological MRI and IVDs were divided as to whether they were affected by scoliotic deformity, i.e., proximal (affected, aIVDs) or distal (unaffected, uaIVDs) to the stable vertebra of the most distal scoliotic curve. Linear mixed models were used to compare mean gagCEST-values. Over all segments, AIS-patients’ IVDs exhibited significantly lower gagCEST-values than the controls: 2.76 [2.32, 3.20]% (AIS), 3.51 [3.16, 3.86]% (Control); p = 0.005. Meanwhile, no significant differences were found for gagCEST values comparing aIVDs with uaIVDs. In conclusion, as a powerful diagnostic adjunct, gagCEST imaging may be prospectively applied to detect early compositional degenerative changes in patients suffering from AIS.
Highlights
adolescent idiopathic scoliosis (AIS) patients being significantly younger than healthy controls (p < 0.001)
The most important finding of this study was that GAG chemical exchange saturation transfer (gagCEST) values in lumbar intervertebral disc (IVD) of AIS patients were significantly lower than those of healthy controls, thereby indicating of AIS patients were significantly lower than those of healthy controls, thereby indicating premorphologic IVD degeneration secondary to the specific biomechanics associated with premorphologic IVD degeneration secondary to the specific biomechanics associated with scoliotic curvatures
Regardless of the exact relationship of solid and fluid IVD components, histologic data suggest that decreases or depletion of GAGs are not present in severely scoliotic segments. These results indicate that aberrant loading, as it occurs in patients with neuromuscular scoliosis, does not directly affect GAG content [28], which is in accordance with our study
Summary
Adolescent idiopathic scoliosis (AIS) is the most common subtype of all idiopathic scolioses with an overall prevalence of 0.5–5.2% and a female predominance [1]. With the disease progressing continuously during the growth of patients, AIS can cause significant back pain, restricted mobility, severe rib deformity, and, thoracic insufficiency in advanced stages [2,3]. Scoliotic deformity in AIS leads to remodeling of the intervertebral discs (IVDs) with consecutive morphologic IVD degeneration, frequently associated with lower back pain [4,5,6]. In severe AIS, the treatment of choice is spinal 3-dimensional deformity correction and fusion after skeletal maturity. Selective fusion [7] is performed by sparing fusion of minor curves, i.e., less affected spinal segments. Short segment fusion leads to less frequent
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
