Abstract
In this paper, the application of 3-dimensional (3D) functional magnetic resonance imaging (FMRI) in the diagnosis of the 5th lumbar (L5) nerve root compression and brain functional areas in patients with lumbar disc herniation (LDH) was analyzed. The traditional fast independent component analysis (Fast ICA) algorithm was optimized based on the modified whitening matrix to establish a new type of Modified-Fast ICA (M-Fast ICA) algorithm that was compared with the introduced traditional Fast ICA and ICA. M-Fast ICA was applied to the 3D FMRI diffusion tensor imaging (DTI) evaluation of 65 patients with L5 nerve root pain due to LDH (group A) and 50 healthy volunteers (group B). The values of fractional anisotropy (FA) and apparent diffusion coefficient (ADC) in the lumbar nerve roots (L3, L4, L5, and the 1st sacral vertebra (S1)) were recorded among subjects from the two groups. Besides, the score of edema degree in the lumbar nerve roots (L5 and S1) and activity of brain functional areas were also recorded among all subjects of the two groups. The results showed that the mean square error of M-Fast ICA was smaller than that of traditional Fast ICA and ICA, while its signal-to-noise ratio (SNR) was greater than that of Fast ICA and ICA (P < 0.05). The FA of L5 and S1 nerve roots in patients of group A was sharply lower than the values of group B, while the ADC of patients in group A was greater than that of the control group (P < 0.05). Besides, the score of edema in L5 and S1 nerve roots of patients in group A increased in contrast to group B (P < 0.05). The brain areas were activated after surgery including bilateral temporal lobe, left thalamus, splenium of corpus callosum, and right internal capsule. In conclusion, the 3D image denoising performance of M-Fast ICA optimized and constructed in this study was superior to that of the traditional Fast ICA and ICA. The FA of patients with L5 nerve root pain due to LDH decreased steeply, while the ADC increased dramatically. L5 nerve root pain caused by LDH resulted in changes in brain functional areas of the patients to inhibit the resting state default network activity, and the corresponding brain functional areas could be activated through treatment.
Highlights
LDH is a common and frequent-occurring disease in spine surgery, and low back pain and lumbocrural pain are the most common causes
Conclusion is study optimized the traditional Fast ICA based on the modified whitening matrix to construct the M-Fast ICA that was compared with the introduced traditional Fast ICA and ICA
M-Fast ICA was adopted to the 3D DTI evaluation of 65 patients with L5 nerve root pain caused by LDH and 50 healthy volunteers
Summary
LDH is a common and frequent-occurring disease in spine surgery, and low back pain and lumbocrural pain are the most common causes. Its clinical manifestations include low back pain, sciatica, and lower extremity radiation pain and weakness, and patients with severe symptoms suffer from incontinence of defecation and urination and abnormal. The main pathogenic factors of this disease include degenerative changes, annulus fibrosus disruption, or nerve root and cauda equina nerve stimulated and compressed by disc herniation in various parts of lumbar intervertebral disc (nucleus pulposus, annulus fibrosus, and cartilage plate) [3]. The incidence of L4-L5 and L5-S1 is the highest of patients with LDH, accounting for about 95% of the whole symptoms, while the incidence of multiple intervertebral disc herniation only occupies about 15%. LDH cannot be completely cured, and most patients need mild conservative treatment to alleviate the disease. erefore, it is very important to discuss the compression conditions of each lumbar vertebra in patients with LDH [6]
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