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Diffusion-Weighted MRI Assessment of Adjacent Disc Degeneration After Thoracolumbar Vertebral Fractures

  • Clinical Investigation
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Abstract

Objective

The purpose of this study was to assess, by the mean apparent diffusion coefficient (ADC), if a relationship exists between disc ADC and MR findings of adjacent disc degeneration after thoracolumbar fractures treated by anatomic reduction using vertebral augmentation (VAP).

Materials and Methods

Twenty non-consecutive patients (mean age 50.7 years; range 45–56) treated because of vertebral fractures, were included in this study. There were 10 A3.1 and 10 A1.2 fractures (AO classification). Surgical treatment using VAP was applied in 14 cases, and conservative in 6 patients. MRI T2-weighted images and mapping of apparent diffusion coefficient (ADC) of the intervertebral disc adjacent to the fractured segment were performed after a mean follow-up of 32 months. A total of 60 discs, 3 per patient, were analysed: infra-adjacent, supra-adjacent and a control disc one level above the supra-adjacent.

Results

No differences between patients surgically treated and those following a conservative protocol regarding the average ADC values obtained in the 20 control discs analysed were found. Considering all discs, average ADC in the supra-adjacent level was lower than in the infra-adjacent (1.35 ± 0.12 vs. 1.53 ± 0.06; p < 0.001). Average ADC values of the discs used as a control were similar to those of the infra-adjacent level (1.54 ± 0.06). Compared to surgically treated patients, discs at the supra-adjacent fracture level showed statistically significant lower values in cases treated conservatively (p < 0.001). The variation in the delay of surgery had no influence on the average values of ADC at any of the measured levels.

Conclusions

ADC measurements of the supra-adjacent discs after a mean follow-up of 32 months following thoracolumbar fractures, showed that restoration of the vertebral collapse by minimally invasive VAP prevents posttraumatic disc degeneration.

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Authors and Affiliations

  1. Spine Department, Valladolid University Hospital, Calle Ramon y Cajal 3, 47005, Valladolid, Spain

    David C. Noriega & Francisco Ardura

  2. Department of Radiology, SS. Trinità Hospital ASL 8 Cagliari, Via Is Mirrionis 92, 09121, Cagliari, Italy

    Stefano Marcia

  3. Radiology Department, Valladolid University Hospital, Calle Ramon y Cajal 3, 47005, Valladolid, Spain

    Israel Sanchez Lite

  4. Department of Radiology, Azienda Ospedaliero Brotzu (A.O.B.), Cagliari, Italy

    Mariangela Marras

  5. Department of Radiology, Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari – Polo di Monserrato s.s. 554, 09045, Monserrato, Cagliari, Italy

    Luca Saba

Authors
  1. David C. Noriega
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  2. Stefano Marcia
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Correspondence to Luca Saba.

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Conflict of Interest

David C Noriega has nothing to disclose. Stefano Marcia has nothing to disclose. Francisco Ardura has nothing to disclose. Israel Sanchez Lite has nothing to disclose. Mariangela Marras has nothing to disclose. Luca Saba has nothing to disclose.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in this study.

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Noriega, D.C., Marcia, S., Ardura, F. et al. Diffusion-Weighted MRI Assessment of Adjacent Disc Degeneration After Thoracolumbar Vertebral Fractures. Cardiovasc Intervent Radiol 39, 1306–1314 (2016). https://doi.org/10.1007/s00270-016-1369-3

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  • DOI: https://doi.org/10.1007/s00270-016-1369-3

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