Low back pain patients and controls display functional differences in endplates and vertebrae measured with T2-mapping

Low back pain patients and controls display functional differences in endplates and vertebrae measured with T2-mapping

K. Lagerstrand, H. Hebelka, H. Brisby

November 2018, pp 1 - 7
DOI
10.1007/s00586-018-5824-5
First Online: 17 November 2018
Abstract

Purpose

The aim was to (1) verify our previous finding that endplates (EPs) display load-induced T2-changes, (2) investigate whether vertebrae display load-induced T2-changes and (3) investigate whether EPs and vertebrae in LBP patients and controls display T2-differences during conventional unloaded MRI and axial loaded MRI (alMRI).

Methods

Twenty-seven patients (mean 39 years) and 12 (mean 38 years) controls were examined with T2-mapping on a 1.5 T scanner during conventional unloaded MRI and subsequently during alMRI (Dynawell® loading device), separated by approximately 20 min. For determination of EP and vertebral T2-values, volumetric regions of interest were manually segmented. Each vertebra was then divided into half to obtain superior and inferior units. The presence of EP changes (visual inhomogeneity in the EP zone), Schmorl’s nodules and Modic changes were registered.

Results

For conventional unloaded MRI, the T2-values in the superior and inferior vertebral units and the EPs were significantly higher in the patients compared with controls (p 

Conclusion

This study demonstrated significantly higher EP and vertebral T2-values in LBP patients in comparison with controls. In addition, alMRI induced significant T2-changes in the superior EPs for patients but not for controls. Importantly, the T2-differences between the groups may indicate that EPs and vertebrae in LBP patients have altered biodynamical characteristics compared to controls and the higher T2-values measured in patients may represent early inflammation or impaired nutritional transport.

Graphical abstract

These slides can be retrieved from electronic supplementary material.[Figure not available: see fulltext.]