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In vivo intervertebral disc mechanical deformation following a treadmill walking “stress test” is inversely related to T1rho relaxation time

  • J.A. Coppock
    Affiliations
    Department of Biomedical Engineering, Duke University, Durham, NC, USA

    Department of Orthopedic Surgery, Duke University School of Medicine, Durham, NC, USA
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  • N.E. Zimmer
    Affiliations
    Department of Biomedical Engineering, Duke University, Durham, NC, USA

    Department of Orthopedic Surgery, Duke University School of Medicine, Durham, NC, USA
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  • Z.A. Englander
    Affiliations
    Department of Biomedical Engineering, Duke University, Durham, NC, USA

    Department of Orthopedic Surgery, Duke University School of Medicine, Durham, NC, USA
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  • S.T. Danyluk
    Affiliations
    Department of Orthopedic Surgery, Duke University School of Medicine, Durham, NC, USA
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  • A.S. Kosinski
    Affiliations
    Department of Biostatistics & Bioinformatics, Duke University, Durham, NC, USA

    Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC, USA
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  • C.E. Spritzer
    Affiliations
    Department of Radiology, Duke University School of Medicine, Durham, NC, USA
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  • A.P. Goode
    Affiliations
    Department of Orthopedic Surgery, Duke University School of Medicine, Durham, NC, USA

    Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC, USA

    Department of Population Health Sciences, Duke University, Durham, NC, USA
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  • L.E. DeFrate
    Correspondence
    Address correspondence and reprint requests to: L.E. DeFrate, Room 379 Medical Sciences Research Bldg, Box 3093, Duke University Medical Center, Durham, NC 27710, USA. Tel.: 919-681-9959 (voice).
    Affiliations
    Department of Biomedical Engineering, Duke University, Durham, NC, USA

    Department of Orthopedic Surgery, Duke University School of Medicine, Durham, NC, USA

    Department of Mechanical Engineering and Materials Science, Duke University, Durham, NC, USA
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Published:September 30, 2022DOI:https://doi.org/10.1016/j.joca.2022.09.008

      Summary

      Objective

      To assess the in vivo relationship between the mechanical response of intervertebral discs (IVDs) to dynamic activity and IVD biochemical composition assessed via T1rho relaxation imaging.

      Design

      Eighteen asymptomatic participants with no history of low back pain (LBP), injury, or surgery underwent magnetic resonance (MR) imaging of their lumbar spine prior to and immediately following a treadmill walking “stress test.” Anatomic (SPACE, FLASH) MR images were obtained pre- and post-exercise and utilized to measure IVD mechanical deformation. Quantitative (T1rho) imaging was performed pre-exercise to reflect IVD composition. Pre-exercise anatomic images were also utilized to assess IVD degenerative status based on the modified Pfirrmann scale. To quantify mechanical response, 3D surface models of the L1-L2–L5-S1 IVDs were created from manual segmentations of pre- and post-exercise anatomic images and utilized to assess changes in IVD height. IVD strain (%) was defined as change in IVD height normalized to pre-activity height. Linear mixed models were used to assess the relationships between IVD mechanical deformation (strain), composition (T1rho relaxation time), and degenerative status (Pfirrmann grade).

      Results

      Increased compressive IVD strain was associated with lower T1rho relaxation times in the nucleus pulposus (NP) of the disc ( β T 1 r h o = 5.07 , C I : [ 1.52 , 7.77 ] , R m a r g 2 = 0.52 , p = 0.005 ) . Thus, an inverse relationship between IVD strain and NP T1rho relaxation time was observed.

      Conclusion

      The in vivo mechanical response of the IVD to the “stress test” was sensitive to differences in NP composition. The results of this study suggest that quantification of in vivo IVD mechanical function and composition may provide insight into IVD health.

      Keywords

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