• Investigative Magnetic Resonance Imaging
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• v.22 no.1
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• pp.18-25
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• 2018

Purpose: To investigate the various imaging factors associated with aggravation of lumbar disc herniation (LDH) and develop a scoring system for prediction of LDH aggravation. Materials and Methods: From 2015 to 2017, we retrospectively reviewed the magnetic resonance imaging (MRI) findings of 60 patients (30 patients with aggravated LDH and 30 patients without any altered LDH). Imaging factors for MRI evaluation included the level of LDH, disc degeneration, back muscle atrophy, facet joint degeneration, ligamentum flavum thickness and interspinous ligament degeneration. Flexion-extension difference was measured with simple radiography. The scoring system was analyzed using receiver operating characteristic (ROC) analysis. Results: The aggravated group manifested a higher grade of disc degeneration, back muscle atrophy and facet degeneration than the control group. The ligamentum flavum thickness in the aggravated group was thicker than in the group with unaltered LDH. The summation score was defined as the sum of the grade of disc degeneration, back muscle atrophy and facet joint degeneration. The area under the ROC curve showing the threshold value of the summation score for prediction of aggravation of LDH was 0.832 and the threshold value corresponded to 6.5. Conclusion: Disc degeneration, facet degeneration, back muscle atrophy and ligamentum flavum thickness are important factors in predicting aggravation of LDH and may facilitate the determination of treatment strategy in patients with LDH. The summation score is available as supplemental data.

• Journal of Veterinary Clinics
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• v.40 no.1
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• pp.38-43
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• 2023

This study compared the degree of disc degeneration of intervertebral disc between normal disc and disc disease using Magnetic Resonance images of tholacolumbar and lumbar vertebrae in dogs. The sample population consisted of 72 dogs and 188 intervertebral discs. These dogs were divided into four groups according to MRI criteria: normal, disc protrusion, disc extrusion, and fibrocartilaginous embolism. The Pfirrmann classification developed by Pfirrmann for use in human medicine was used to assess the degree of disc degeneration. Statistical analysis revealed that disc diseases had a significant difference in the degree of disc degeneration compared to normal discs in the intervertebral disc. Fibrocartilaginous embolism was found to have a relatively low disc degenerative change compared to two other disc disease groups, disc protrusion and disc extrusion. Disc degeneration in the disc extrusion group was slightly higher than that in the disc protrusion group, although the difference between the two groups was not statistically significant.

• The Journal of Korean Physical Therapy
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• v.13 no.1
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• pp.1-18
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• 2001

Aging has been recognized as the primary cause of disc degeneration. A biomechanical characteristics of disc degeneration has been demonstrated that intradiscal pressure is reduced. With the increasing population of elderly people, disc degeneration and associated problems of nerve entrapment are becoming more prevalent. Presently, research on reduced intradiscal pressure associated with degeneration is insufficient. In this study. we used the Finite Element Method (FEM) of computerized simulations to investigate the effects of variation in intradiscal pressure on mechanical behaviours of L4-5 intervertebral disc degeneration. Degeneration was classified using four grades based on initial intradiscal pressure; Normal (135 kPa), mild(107 kPa), moderate (47 kPa) and severe (15 kPa). The predicted results f3r bending loads were as follows; 1 . Range of motion increased progressively with severity of degeneration with flexion and lateral bending moments, but decreased with extension moments. 2. Discal bulging of posterolateral aspect was larger in lateral bending and extension moment. But bulging was increased with severity of degeneration in lateral bending and torsion(same side).3. The rate of increasing intradiscal pressure was decreased in all bending motions with severity of degeneration. In conclusion, lateral bending and extension moment yield greatest bulging in severe degeneration. In torsion, although bending load produces disc bulging, disc bulging was associated more strongly with severity of degeneration than increasing torsional moments. Clinical Implications: Discal bulging may produce nerve root impingement and irritation. The effect of loading and posture on the varying degrees of disc degeneration has important implications especially in the elderly. In the presence of disc degeneration, avoidance of end range postures, especially extension and lateral bending may help reduce discal bulging and in turn, nerve entrapment.

• Clinical Pain
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• v.18 no.1
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• pp.8-15
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• 2019

Objective: To determine the relationship between cervical sagittal parameters and the degree of the cervical disc degeneration at each cervical level by using cervical plain radiographs and disc degeneration grading. Method: This study analyzed 110 patients with posterior neck pain. Cervical radiographic measurements included the occipito-cervical (O~C2) angle; sagittal Cobb angles of C1~C2, C2~C7; and sagittal vertical axis (SVA) of C1~C7 and C2~C7. The degenerations of cervical discs at each level were evaluated through Pfirrmann grading system by magnetic resonance images of the cervical spine. The correlations between the cervical sagittal measurements and the disc degeneration at each level were analyzed by Spearman's correlation. Results: A significant correlation was found for the C2~C7 angle with disc degenerations at C2~C6 levels. O~C2 angle was correlated significantly with disc degenerations at C2~C4 and C5~C7 levels. There was significant correlation between C1~C2 angle and disc degeneration at C6~C7 level. No significant relationship was found between the cervical SVA and the cervical disc degeneration at all cervical levels. Conclusion: Cervical sagittal parameters representing cervical angles (C2~C7, O~C2, and C1~C2 angles) were significantly correlated with the degree of the cervical disc degeneration. These findings suggest that the loss of the natural cervical lordosis rather than loss of natural SVA could be correlated with progression of the cervical disc degeneration.

• Journal of Korean Neurosurgical Society
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• v.44 no.5
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• pp.327-333
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• 2008

Objective: The purpose of this study is to verify the usefulness of the rabbit model for disc degeneration study. Materials: The L1-L2, L2-L3, L3-L4. or L4-L5 lumbar intervertebral disc (IVD) of 9 mature male New Zealand White rabbits were injured by inserting a 16-gauge needle to a depth of 5 mm in the left anterolateral annulus fibrosus while leaving L5-L6 IVD uninjured. Three other rabbits also received intradiscal injections of rabbit disc cells transfected with adenovirus and bone morphogenetic protein-2 (ad-BMP-2) at L4-L5 in addition to injury by 16-gauge needle at the L1-L2 level. Using digitized radiographs, measurements of IVD height were made and analyzed by using the disc height index (DHI). Magnetic resonance imaging (MRI) scans of the injured discs, injected discs, and uninjured L5-L6 discs were performed at 15 weeks post surgery and compared with preoperative MRI scans. Results: All twelve rabbits showed consistent results of disc degeneration within 15 weeks following annular puncture. DHIs of injured discs were significantly lower than that of the uninjured L5-L6 discs (p<0.05). The mean value of disc degeneration grade of injured discs was significantly higher than that of uninjured discs (p<0.05). The injection of disc cell transfected with ad-BMP-2 did not induce disc regeneration at 15 weeks after injection. Conclusion: This study showed that the injured disc had a significant change in DHI on simple lateral radiograph and disc degeneration grade on MRI scans within 15 weeks in all rabbits. Rabbit annular puncture model can be useful as a disc degeneration model in vivo.

• Journal of Korean Neurosurgical Society
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• v.53 no.6
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• pp.323-330
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• 2013

Objective : To develop a simple, reproducible model of disc degeneration in rabbits through percutaneous annular puncture and to confirm the degree of degeneration over time. Methods : Fifteen New Zealand white rabbits (4 to 5 months old and weighing approximately 3 to 3.5 kg each) underwent annular puncture of the L2-L3, L3-L4, and L4-L5 discs. Rabbits were sacrificed at 4, 8, or 20 weeks after puncture. For a longitudinal study to assess changes in disc height over time, serial X-rays were performed at 0, 2, 4, 8, and 20 weeks for rabbits in the 20-week group. Upon sacrifice, the whole spinal column and discs were extracted and analyzed with magnetic resonance imaging (MRI), real time reverse transcriptase-polymerase chain reaction, and histological staining. Results : The X-rays showed a slow, progressive decrease in disc height over time. Significant disc space narrowing compared to preoperative disc height was observed during the time period (p<0.001). The MRI grade, aggrecan, and matrix metalloprotease-13 mRNA expression and hematoxylin and eosin/safranin O/anti-collagen II staining were consistently indicative of degeneration, supporting the results of the X-ray data. Conclusion : Percutaneous annular puncture resulted in slow, reproducible disc degeneration that was confirmed by radiology, biochemistry, and histology. This in vivo model can be used to study and evaluate the safety and efficacy of biologic treatments for degenerative disc disease.

• Journal of Korean Neurosurgical Society
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• v.53 no.1
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• pp.31-38
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• 2013

Objective : Asymptomatic patients show high degeneration prevalence at lumbar disc in previous literatures. Unfortunately, there are few Korean data, so the authors attempted to analyze the prevalence of disc degeneration in highly selective asymptomatic Korean subjects using MRI. Methods : We performed 3 T MRI sagittal scans from T12 to S1 on 102 asymptomatic subjects (50 men and 52 women) who visited our hospital between the ages of 14 and 82 years (mean age 46.3 years). All images were read independently by three observers (two neurosurgeons and one neuroradiologist) who were not given any information about the subjects. We classified grading for lumbar disc herniation (HN), annular fissure (AF), and nucleus degeneration (ND), using disc degeneration classification. Results : The prevalence of HN, AF, and ND were 81.4%, 76.1%, and 75.8% respectively. Almost all levels showed an age-related proportional tendency with some exceptions. Conclusion : In asymptomatic Korean subjects, the abnormal findings showed high prevalence of AF, ND, and extrusion. Especially in young ages, the authors found that bulging, protrusion, and AF showed high prevalence at L4/5 and L5/S1. And ND showed high prevalence at L5/S1. So, all lumbar disc degenerations are not pathologic, especially in children and adolescents.

• Proceedings of the Korean Society of Precision Engineering Conference
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• 2005.10a
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• pp.248-251
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• 2005

To investigate the degeneration process in the intervertebral disc, a three dimensional (3D) poroelastic finite-element (FE) model was developed. Disc was modeled as two different regions, such as annulus modeled with fiber reinforced 20 node poroelastic ground matrix and nucleus having large porosity. Excess Von Mises stress in the disc element assumed to be a possible source of degeneration under compressive loading condition. Recursive calculation was continued until the desired convergence was attained by changing the permeability and porosity of those elements, which could be predicted from the previous iteration. The degenerated disc model showed that relatively small compressive stresses were generated in the nucleus elements compared to normal disc. Its distribution along the sagittal plane was matched well with a previously reported experimental result. Contrasts to this result, pore pressures in the nucleus were higher than those in the normal disc. Total stress indicated similar values for two different models. This new approach using poroelastic modeling could provide the explanation of the interaction between fluid and solid matrix in the disc during the degeneration process.

• Journal of Korean Neurosurgical Society
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• v.53 no.2
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• pp.89-95
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• 2013

Objective : Similar to back pain, neck pain has recently shown to have increasing prevalence. Magnetic resonance imaging (MRI) is useful in identifying the causes of neck pain. However, MRI shows not only pathological lesions but also physiological changes at the same time, and there are few Korean data. The authors have attempted to analyze the prevalence of disc degeneration in highly selective asymptomatic Korean subjects using MRI. Methods : We performed 3 T MRI sagittal scans from C2 to T1 on 102 asymptomatic subjects (50 men and 52 women) who visited our hospital between the ages of 14 and 82 years (mean age 46.3 years). All images were read independently by three observers (two neurosurgeons and one neuroradiologist) who were not given any information about the subjects. We classified grading for cervical disc herniation (HN), annular fissure (AF), and nucleus degeneration (ND), using disc degeneration classification. Results : The prevalence of HN, AF, and ND were 81.0%, 85.9%, and 95.4%, respectively. High prevalence of HN, AF, and ND was shown compared to previous literature. Conclusion : In asymptomatic Korean subjects, the abnormal findings of 3 T MRI showed a high prevalence in HN, AF, and ND. Several factors might play important roles in these results, such as population-specific characters, MRI field strength, and disc degeneration grading system.

• The Journal of Korea CHUNA Manual Medicine
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• v.2 no.1
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• pp.85-92
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• 2001

Objectives : To study the cervical lordosis and disc degeneration in neck pain patients with or without low back pain. Subjects. The study was composed of 57 neck pain patients with low back pain(LBP group) and 40 neck pain patients without low back pain(Non-LBP group). Methods : Radiographic measures of spinal lordosis(cervical and lumbar) and disc degeneration were collected, and statistically analyzed. Results: LBP group showed a significant increase in cervical lordotic angle as compared with Non-LBP group, whereas no significant change in cervical disc degeneration. A relationship was found between cervical and lumbar disc degeneration in LBP $group({\gamma}-0.3064)$. Conclusions : The findings from this study suggest that the curvature of the cervical spine is related to the subject's low back pain.