Novel diagnostic and prognostic methods for disc degeneration and low back pain

doi:10.1016/j.spinee.2014.09.010

Review

. 2015 Sep 1;15(9):1919-32.

doi: 10.1016/j.spinee.2014.09.010.

Novel diagnostic and prognostic methods for disc degeneration and low back pain

Dino Samartzis¹, Ari Borthakur², Inna Belfer³, Cora Bow⁴, Jeffrey C Lotz⁵, Hai-Qiang Wang⁶, Kenneth M C Cheung⁴, Eugene Carragee⁷, Jaro Karppinen⁸

Affiliations

¹ Department of Orthopaedics and Traumatology, The University of Hong Kong, Professorial Block, 5th Floor, 102 Pokfulam Road, Pokfulam, Hong Kong, SAR, China; The Laboratory and Clinical Research Institute for Pain, The University of Hong Kong, 102 Pokfulam Road, Pokfulam, Hong Kong, SAR, China. Electronic address: dsamartzis@msn.com.
² Center for Magnetic Resonance and Optical Imaging, Department of Radiology, Perelman School of Medicine at the University of Pennsylvania, 3535 Market Street, Mezzanine, Philadelphia, PA, 19104, USA.
³ Department of Anesthesiology, University of Pittsburgh, 4200 Fifth Ave, Pittsburgh, PA 15260, USA.
⁴ Department of Orthopaedics and Traumatology, The University of Hong Kong, Professorial Block, 5th Floor, 102 Pokfulam Road, Pokfulam, Hong Kong, SAR, China.
⁵ Department of Orthopaedic Surgery, University of California at San Francisco, 500 Parnassus Ave, San Francisco, CA 94143, USA.
⁶ Department of Orthopaedics, Xijing Hospital, Fourth Military Medical University, No. 169, Changle West Road, Xi'an, Shaanxi, 710032, P.R. China.
⁷ Department of Orthopaedic Surgery, Stanford University, 450 Serra Mall, Stanford, CA 94305, USA.
⁸ Medical Research Center Oulu, University of Oulu, Oulu University Hospital, Kajaanintie 50, 90220 Oulu, Finland.

PMID: 26303178
PMCID: PMC5473425
DOI: 10.1016/j.spinee.2014.09.010

Review

Novel diagnostic and prognostic methods for disc degeneration and low back pain

Dino Samartzis et al. Spine J. 2015.

. 2015 Sep 1;15(9):1919-32.

doi: 10.1016/j.spinee.2014.09.010.

Authors

Dino Samartzis¹, Ari Borthakur², Inna Belfer³, Cora Bow⁴, Jeffrey C Lotz⁵, Hai-Qiang Wang⁶, Kenneth M C Cheung⁴, Eugene Carragee⁷, Jaro Karppinen⁸

Affiliations

¹ Department of Orthopaedics and Traumatology, The University of Hong Kong, Professorial Block, 5th Floor, 102 Pokfulam Road, Pokfulam, Hong Kong, SAR, China; The Laboratory and Clinical Research Institute for Pain, The University of Hong Kong, 102 Pokfulam Road, Pokfulam, Hong Kong, SAR, China. Electronic address: dsamartzis@msn.com.
² Center for Magnetic Resonance and Optical Imaging, Department of Radiology, Perelman School of Medicine at the University of Pennsylvania, 3535 Market Street, Mezzanine, Philadelphia, PA, 19104, USA.
³ Department of Anesthesiology, University of Pittsburgh, 4200 Fifth Ave, Pittsburgh, PA 15260, USA.
⁴ Department of Orthopaedics and Traumatology, The University of Hong Kong, Professorial Block, 5th Floor, 102 Pokfulam Road, Pokfulam, Hong Kong, SAR, China.
⁵ Department of Orthopaedic Surgery, University of California at San Francisco, 500 Parnassus Ave, San Francisco, CA 94143, USA.
⁶ Department of Orthopaedics, Xijing Hospital, Fourth Military Medical University, No. 169, Changle West Road, Xi'an, Shaanxi, 710032, P.R. China.
⁷ Department of Orthopaedic Surgery, Stanford University, 450 Serra Mall, Stanford, CA 94305, USA.
⁸ Medical Research Center Oulu, University of Oulu, Oulu University Hospital, Kajaanintie 50, 90220 Oulu, Finland.

PMID: 26303178
PMCID: PMC5473425
DOI: 10.1016/j.spinee.2014.09.010

No abstract available

PubMed Disclaimer

Figures

**Fig. 1**
Sagittal T2-weighted magnetic resonace imaging of the lumbar spine. (Left) Normal hydrated discs manifesting as high signal intensity in an asymptomatic subject. (Right) Loss of disc signal intensity, with multiple levels of decreased disc height, Modic changes, end-plate abnormalities, disc displacement, and loss of lumbar lordosis in an individual with low back pain.

**Fig. 2**
Representative proton T2 magnetic resonace imaging (gray scale) and corresponding T1ρ maps (in color overlaid on gray-scale T1ρ-weighted image) of the lumbar discs from (Left) a 52-year-old female and (Middle) a 35-year-old male patients diagnosed with low back pain and from (Right) an asymptomatic 38-year-old man. Average T1ρ (in milliseconds) was measured in the disc nucleus and is displayed below each disc, followed by the opening pressure (in psi) and whether discs were painful (P) or nonpainful (N), both determined by discography are indicated in the lower back pain patients [136].

**Fig. 3**
A glycosaminoglycan map of the intervertebral disc is determined using the magnetic resonace imaging glycosaminoglycan chemical exchange saturation transfer (gagCEST) method in two subjects: (Top) a 25-year-old woman at L5–S1 and (Bottom) a 54-year-old man at L5–S1. The nucleus pulposus is delineated from the annulus fibrosus (AF) region by the dotted oval in the 1.5-ppm images. The gagCEST maps are shown at different frequency offsets relative to water at 0 ppm. In both subjects, the gagCEST effect is highest in the 0.75- to 1-ppm range of frequency offsets [84].

**Fig. 4**
(Left) T2-weighted magnetic resonace imaging (MRI) of the lumbar spine and its corresponding (Right) ultrashort time-to-echo MRI.

**Fig. 5**
Representative proton T2-weighted magnetic resonace imaging (gray scale) and corresponding sodium maps (color) obtained in vivo. (Top) A 22-year-old man with lower lumbar trauma that resulted in chronic low back pain. (Bottom) A 26-year-old asymptomatic man [98].

See this image and copyright information in PMC

Comment in

Bringing truths from evidence: novel ways to detect pain derivation of low back.
Zhang J, Su JB. Zhang J, et al. Spine J. 2016 May;16(5):676. doi: 10.1016/j.spinee.2015.10.059. Spine J. 2016. PMID: 27261846 No abstract available.

Cited by

Classification of High Intensity Zones of the Lumbar Spine and Their Association with Other Spinal MRI Phenotypes: The Wakayama Spine Study.
Teraguchi M, Samartzis D, Hashizume H, Yamada H, Muraki S, Oka H, Cheung JP, Kagotani R, Iwahashi H, Tanaka S, Kawaguchi H, Nakamura K, Akune T, Cheung KM, Yoshimura N, Yoshida M. Teraguchi M, et al. PLoS One. 2016 Sep 20;11(9):e0160111. doi: 10.1371/journal.pone.0160111. eCollection 2016. PLoS One. 2016. PMID: 27649071 Free PMC article.
The relationship between chest pain intensity and physiological indicators after coronary artery bypass grafting: A correlational study.
Fakhr-Movahedi A, Zarei A, Ebrahimian A. Fakhr-Movahedi A, et al. Turk Gogus Kalp Damar Cerrahisi Derg. 2019 Apr 24;27(2):173-177. doi: 10.5606/tgkdc.dergisi.2019.17517. eCollection 2019 Apr. Turk Gogus Kalp Damar Cerrahisi Derg. 2019. PMID: 32082849 Free PMC article.
Advancing cell therapies for intervertebral disc regeneration from the lab to the clinic: Recommendations of the ORS spine section.
Smith LJ, Silverman L, Sakai D, Le Maitre CL, Mauck RL, Malhotra NR, Lotz JC, Buckley CT. Smith LJ, et al. JOR Spine. 2018 Dec;1(4):e1036. doi: 10.1002/jsp2.1036. Epub 2018 Oct 8. JOR Spine. 2018. PMID: 30895277 Free PMC article. Review.
Low back pain in older adults: risk factors, management options and future directions.
Wong AYL, Karppinen J, Samartzis D. Wong AYL, et al. Scoliosis Spinal Disord. 2017 Apr 18;12:14. doi: 10.1186/s13013-017-0121-3. eCollection 2017. Scoliosis Spinal Disord. 2017. PMID: 28435906 Free PMC article. Review.
The UTE Disc Sign on MRI: A Novel Imaging Biomarker Associated With Degenerative Spine Changes, Low Back Pain, and Disability.
Pang H, Bow C, Cheung JPY, Zehra U, Borthakur A, Karppinen J, Inoue N, Wang HQ, Luk KDK, Cheung KMC, Samartzis D. Pang H, et al. Spine (Phila Pa 1976). 2018 Apr 1;43(7):503-511. doi: 10.1097/BRS.0000000000002369. Spine (Phila Pa 1976). 2018. PMID: 28767621 Free PMC article.

See all "Cited by" articles

References

1. Vos T, Flaxman AD, Naghavi M, Lozano R, Michaud C, Ezzati M, et al. Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380:2163–96. - PMC - PubMed
1. Andersson GB. Epidemiological features of chronic low-back pain. Lancet. 1999;354:581–5. - PubMed
1. Ekman M, Jonhagen S, Hunsche E, Jonsson L. Burden of illness of chronic low back pain in Sweden: a cross-sectional, retrospective study in primary care setting. Spine. 2005;30:1777–85. - PubMed
1. Deyo RA, Tsui-Wu YJ. Descriptive epidemiology of low-back pain and its related medical care in the United States. Spine. 1987;12:264–8. - PubMed
1. Shen FH, Samartzis D, Andersson GB. Nonoperative management of acute and chronic low back pain. J Am Acad Ortho Surg. 2006;14:477–87. - PubMed

Publication types

Actions
Actions
Actions

MeSH terms

Actions
Actions
Actions
Actions
Actions
Actions
Actions

Grants and funding

LinkOut - more resources

Full Text Sources
Other Literature Sources
- scite Smart Citations
Medical
- MedlinePlus Health Information

[1] Vos T, Flaxman AD, Naghavi M, Lozano R, Michaud C, Ezzati M, et al. Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380:2163–96. - PMC - PubMed

[2] Vos T, Flaxman AD, Naghavi M, Lozano R, Michaud C, Ezzati M, et al. Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380:2163–96. - PMC - PubMed

[3] Andersson GB. Epidemiological features of chronic low-back pain. Lancet. 1999;354:581–5. - PubMed

[4] Andersson GB. Epidemiological features of chronic low-back pain. Lancet. 1999;354:581–5. - PubMed

[5] Ekman M, Jonhagen S, Hunsche E, Jonsson L. Burden of illness of chronic low back pain in Sweden: a cross-sectional, retrospective study in primary care setting. Spine. 2005;30:1777–85. - PubMed

[6] Ekman M, Jonhagen S, Hunsche E, Jonsson L. Burden of illness of chronic low back pain in Sweden: a cross-sectional, retrospective study in primary care setting. Spine. 2005;30:1777–85. - PubMed

[7] Deyo RA, Tsui-Wu YJ. Descriptive epidemiology of low-back pain and its related medical care in the United States. Spine. 1987;12:264–8. - PubMed

[8] Deyo RA, Tsui-Wu YJ. Descriptive epidemiology of low-back pain and its related medical care in the United States. Spine. 1987;12:264–8. - PubMed

[9] Shen FH, Samartzis D, Andersson GB. Nonoperative management of acute and chronic low back pain. J Am Acad Ortho Surg. 2006;14:477–87. - PubMed

[10] Shen FH, Samartzis D, Andersson GB. Nonoperative management of acute and chronic low back pain. J Am Acad Ortho Surg. 2006;14:477–87. - PubMed

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

Novel diagnostic and prognostic methods for disc degeneration and low back pain

Affiliations

Novel diagnostic and prognostic methods for disc degeneration and low back pain

Authors

Affiliations

Figures

Comment in

Similar articles

Cited by

References

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Other Literature Sources

Medical