Abstract
Low back pain (LBP) is one of the leading causes of disability worldwide, with a significant socioeconomic burden on healthcare systems. It is mainly caused by degenerative disc disease (DDD), a progressive, chronic, and age-related process. With its capacity to accurately characterize intervertebral disc (IVD) and spinal morphology, magnetic resonance imaging (MRI) has been established as one of the most valuable tools in diagnosing DDD. However, existing technology cannot detect subtle changes in IVD tissue composition and cell metabolism. In this review, we summarized the state of the art regarding innovative quantitative MRI modalities that have shown the capacity to discriminate and quantify changes in matrix composition and integrity, as well as biomechanical changes in the early stages of DDD. Validation and implementation of this new technology in the clinical setting will allow for an early diagnosis of DDD and ideally guide conservative and regenerative treatments that may prevent the progression of the degenerative process rather than intervene at the latest stages of the disease.
Highlights
Low back pain (LBP) is one of the leading causes of disability worldwide, with a peak prevalence in adult and elderly patients
Axial spinal pain and neuralgia can arise from degenerative conditions of the spine, including facet joint syndrome, sacroiliac joint osteoarthritis, and degenerative disc disease (DDD)
They are composed of (1) the annulus fibrosus (AF), which is a peripheral structure formed by 15–40 dense parallel concentric lamellae rich in type I collagen that provide resistance against tensile forces [2,3], and (2) the nucleus pulposus (NP), which is the central part of the intervertebral disc (IVD), enveloped in the AF, providing loading and compressive resistance
Summary
Low back pain (LBP) is one of the leading causes of disability worldwide, with a peak prevalence in adult and elderly patients. It represents a severe economic and social burden on healthcare systems [1]. Other changes in disc material characteristics with abnormalities of AF tensile properties occur, leading to structural damage, such as disc height reduction, annular tears, rim lesions, and osteophyte formation [9,11]. Innovative MRI techniques have been investigating diverse parameters, including relaxation times, magnetization transfer (MT), spectroscopy, and apparent diffusion coefficient (ADC), to analyze the biochemical composition of the IVD at different stages of DDD. We summarized the state of the art regarding the latest MRI technology for diagnosing DDD, describing in detail the novel methodologies and tools that have been under development to detect DDD at the earliest stages
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