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Association between intervertebral disc degeneration and endplate perfusion studied by DCE-MRI

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Abstract

Purpose

The goal of this study was to study the association between solute transport mechanisms in cartilaginous disc endplates and the degeneration of intervertebral discs. Intervertebral disc degeneration is a multi-factorial process. It is suspected that poor nutrient delivery to discs might be a factor leading to degeneration. Several studies suggest that defects in disc endplates could lead to poor transport of nutrients. An imaging technique assessing endplate perfusion could be a valuable tool in investigating disc degeneration. There is currently no universally accepted technique assessing endplate perfusion in vivo.

Methods

Nine adult patients exhibiting varying levels of intervertebral disc degeneration were included. MRI was used to study the association between blood perfusion in 90 lumbar disc endplates and disc degeneration in 45 lumbar discs. Solute transport mechanism through endplates was assessed indirectly by dynamic contrast enhanced (DCE) MRI. T2-weighted MRI was used for conventional Pfirrmann classification.

Results

A positive association was observed between Pfirrmann grades and endplate DCE-MRI enhancement. A differential enhancement between cranial and caudal endplates was also observed, which increased with Pfirrmann grades. This differential enhancement was also dependent on the lumbar level.

Conclusions

Increased MRI signal enhancement in the cartilaginous endplates of degenerated discs might indicate damage to the subchondral bone of the vertebral bodies. The endplate enhancement characteristic could aid in understanding the pathophysiology of disc degeneration and planning treatment more effectively.

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Acknowledgments

This study is supported in part by funds from Advancing a Healthier Wisconsin FP00002161, AOSpine Clinical Priority program and also from Orthopedic Education and Research Institute of Southern California, a non-profit research institute which received funds from Cardiovascular BioTherapeutics Inc. We also would like to thank Aniko Szabo, Ph.D. and Qun Xiang, M.Sc. from the Division of Biostatistics, Institute for Health and Society at MCW for their assistance in statistical analyses.

Conflict of interest

None of the authors has any potential conflict of interest.

Ethical standard

This study was approved by the Institutional Review Board of the University of California, Irvine, where the study was conducted.

Author information

Authors and Affiliations

  1. Department of Neurosurgery, Medical College of Wisconsin, Froedtert Hospital, 9200 W. Wisconsin Ave., Milwaukee, WI, 53226, USA

    L. Tugan Muftuler, Dennis J. Maiman & Volkan Emre Arpinar

  2. Center for Imaging Research, Medical College of Wisconsin, Milwaukee, WI, 53226, USA

    L. Tugan Muftuler

  3. Medical College of Wisconsin, Milwaukee, WI, 53226, USA

    Joshua P. Jarman

  4. Department of Radiological Sciences and Center for Functional Onco-Imaging, University of California, Irvine, 92697, USA

    Hon J. Yu

  5. Orthopaedic Education and Research Institute of Southern California, Orange, CA, USA

    Vance O. Gardner

Authors
  1. L. Tugan Muftuler
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  2. Joshua P. Jarman
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  3. Hon J. Yu
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  4. Vance O. Gardner
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  5. Dennis J. Maiman
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Correspondence to L. Tugan Muftuler.

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Muftuler, L.T., Jarman, J.P., Yu, H.J. et al. Association between intervertebral disc degeneration and endplate perfusion studied by DCE-MRI. Eur Spine J 24, 679–685 (2015). https://doi.org/10.1007/s00586-014-3690-3

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  • DOI: https://doi.org/10.1007/s00586-014-3690-3

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