T1? MRI AS A QUANTITATIVE BIOMARKER OF DISC DEGENERATION IN VIVO

$17,344P41FY2010RRNIH

University Of Pennsylvania, Philadelphia PA

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Abstract

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Degenerative disc disease (DDD) of the intervertebral disc (IVD) in its early stage is caused in part by the loss of proteoglycan in the nucleus pulpous (NP) of the IVD. Degenerate discs eventually have decreased height but are confounded with changes that occur in disc height as a result of normal aging. The Pfirrmann grade determined from T2 MRI is currently the gold standard to determine disc degeneration. This method, however, relies on subjective observer-scored morphologic features of the disc. A quantitative assessment of disc health is essential for selection of treatment options and to the future of biomedical research in the development of new spine technologies. A potential quantitative indicator of degeneration is the opening pressure (OP), defined as the pressure where injected fluid first overcomes the internal osmotic pressure and enters the disc. However, this method is invasive and relies on the patient's perception of pain. The disc height ratio (DHR), the average disc height normalized by the width of the disc, can be measured from conventional MRI, and provides a measure of disease progression. The non-invasive technique of T1[unreadable] MRI may be advantageous in objectively detecting DDD at an earlier stage than the DHR, since it is sensitive to biochemical changes in the tissue that precede disc height changes. The objective of this study is to evaluate T1[unreadable] MRI as quantitative biomarker of disc degeneration in patients being treated for LBP. These patients, and others still being recruited to the study, will be followed over the next several years to determine the change in NP T1[unreadable] of adjacent non-operative levels and thus evaluate for potential progression of disc degeneration

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