Artikel
Is it possible to detect the biochemical status of a degenerated disc in human cervical spine with imaging techniques (X-ray, MRI, dGEMRIC)? – An in vivo pilot study
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Autoren
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Richard Bostelmann
- Klinik für Neurochirurgie, Universitätsklinik Düsseldorf, Düsseldorf, Germany
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A. Nasca
- Klinik für Neurochirurgie, Universitätsklinik Düsseldorf, Düsseldorf, Germany
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T. Bostelmann
- Klinik für Neurochirurgie, Universitätsklinik Düsseldorf, Düsseldorf, Germany
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Christoph Schleich
- Klinik für Radiologie, Universitätsklinik Düsseldorf, Düsseldorf, Germany
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Hans-Jakob Steiger
- Klinik für Neurochirurgie, Universitätsklinik Düsseldorf, Düsseldorf, Germany
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Frank Zaucke
- Institut für Biochemie II, Medizinische Fakultät der Universität Köln, Köln, Germany
| Veröffentlicht: | 8. Juni 2016 |
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Gliederung
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Objective: Post-mortem studies show that the maturation and degeneration of human intervertebral discs do correlate with the disc’s content of glycosaminoglycans (GAGs), which differ according to the degenerative status in the nucleus pulposus (NP) and annulus fibrosus (AF). Currently there is no in-vivo human research demonstrating a biochemical correlation of cervical spinal disc GAG content with ubiquitously available imaging techniques. The aim of this pilot study is to investigate, (1) the GAG content in human cervical discs, (2) whether a topographic biochemical GAG pattern can be found, and (3) whether there is a correlation between imaging data (X-ray and MRI - incl. dGEMRIC as a special imaging technique of cartilage) and the biochemical data.
Method: After surgical removal of 12 human cervical intervertebral discs their 96 (segments (8 per disc) were biochemically analyzed using Blyscan Assay (tebu-bio GmbH, Germany). The specimens' GAG content was compared to X-ray, MRI and MRI in dGEMRIC-sequence images. The statistical correlation and analysis was performed using SPSS 22.0 (SPSS inc., Chicago, IL, USA).
Results: A quantitative pattern of GAG was identified. Moreover we found (1) significantly (p<0.001) higher values of GAGs (µg GAG/mg tissue, dw) in the NP 169.9 (SD 37.3) than in the AF 132.4 (SD 42.2), (2) significantly (p<0.005) higher values of GAGs in the dorsal (right/left: 149.9/160.2) than in the ventral (right/left: 112.0/120.2) part of the AF, (3) in dGEMRIC imaging a significantly (p<0.008) different distribution of GAGs in the cervical disc (NP 1083.3ms (SD 248.6) than in AF 925.9ms (SD 137.6)), and (4) that grading of disc degeneration in Xray or MRI was not significantly correlated with AF, nor NP GAG content.
Conclusions: We could show that (1) the GAG content in human cervical discs can be detected in vivo and (2) is subject to a region-specific pattern (AF-NP; anterior-posterior). This biochemical data is reproducible with dGEMRIC-MRI, but not with X-ray or MRI. Potentially dGEMRIC imaging can be used as a non-invasive in-vivo indicator of disc degeneration in the cervical column.
