Correlations between radiographic, magnetic resonance and histological examinations on the degeneration of human lumbar intervertebral discs

Authors

  • Delio Eulalio Martins Universidade Federal de São Paulo
  • Valdeci Manoel de Oliveira Universidade Federal de São Paulo
  • Maria Teresa de Seixas Alves Universidade Federal de São Paulo
  • Marcelo Wajchenberg Universidade Federal de São Paulo
  • Élcio Landim Universidade Federal de São Paulo
  • João Carlos Belloti Universidade Federal de São Paulo
  • Eduardo Barros Puertas Universidade Federal de São Paulo
  • Akira Ishida Universidade Federal de São Paulo

Keywords:

Intervertebral disk, Spine, Magnetic resonance spectroscopy, Radiography, Nerve endings, Comparative study [Publication type]

Abstract

Context and ObjeCtive: There is controversy regarding which imaging method is best for identifying early degenerative alterations in intervertebral discs. No correlations between such methods and histological finds are presented in the literature. The aim of this study was to correlate the thickness of intervertebral discs measured on simple radiographs with the degree of degeneration seen on magnetic resonance images and the histological findings relating to nerve ends inside the discs. design and setting: Cross-sectional correlation study on the lumbar spines of human cadavers, at Universidade Federal de São Paulo (Unifesp), São Paulo, Brazil. Methods: Ten lumbar spinal columns were extracted from human cadavers and subjected to magnetic resonance imaging and simple radiography. They were classified according to the degree of disc degeneration seen on magnetic resonance, and the thickness of the discs was measured on radiographs. The intervertebral discs were then extracted, embedded in paraffin and analyzed immunohistochemically with protein S100, and the nerve fibers were counted and classified. Results: No correlation was observed between the thickness of the intervertebral discs and the degree of degeneration seen on magnetic resonance images. Only the uppermost lumbar discs (L1/L2 and L2/L3) presented a correlation between their thickness and type I and IV nerve endings. Conclusion: Reduced disc thickness is unrelated to increased presence of nerve ends in intervertebral discs, or to the degree of disc degeneration.

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Author Biographies

Delio Eulalio Martins, Universidade Federal de São Paulo

MD. Attending physician in the Spine Group, Department of Orthopedics and Traumatology, Universidade Federal de São Paulo (Unifesp), São Paulo, Brazil.

Valdeci Manoel de Oliveira, Universidade Federal de São Paulo

MD, PhD. Adjunct professor of Anatomy, Faculdade de Ciências Médicas e da Saúde de Juiz de Fora (FCMS/JF), and deputy professor of Orthopedics and Traumatology, School of Medicine, Universidade Federal Juiz de Fora (UFJF), Juiz de Fora, Minas Gerais, Brazil.

Maria Teresa de Seixas Alves, Universidade Federal de São Paulo

MD, PhD. Adjunct professor and head of General Pathological Anatomy, Forensics and Bioethics, Department of Pathology, Universidade Federal de São Paulo (Unifesp), São Paulo, Brazil.

Marcelo Wajchenberg, Universidade Federal de São Paulo

MD, MSc. Attending physician in the Spine Group, Department of Orthopedics and Traumatology, Universidade Federal de São Paulo (Unifesp), São Paulo, Brazil.

Élcio Landim, Universidade Federal de São Paulo

MD, PhD. Assistant professor, Department of Orthopedics and Traumatology, Faculdade de Ciências Médicas da Santa Casa de São Paulo, and head of Scoliosis Group, Associação de Assistência à Criança Deficiente (AACD) de São Paulo, São Paulo, Brazil.

João Carlos Belloti, Universidade Federal de São Paulo

MD, PhD. Doctor of Science, associate professor, Department of Orthopedics and Traumatology, Universidade Federal de São Paulo, São Paulo, Brazil.

Eduardo Barros Puertas, Universidade Federal de São Paulo

MD, PhD. Associate professor and head of Traumatology, Department of Orthopedics and Traumatology, Universidade Federal de São Paulo (Unifesp), São Paulo, Brazil.

Akira Ishida, Universidade Federal de São Paulo

MD, PhD. Full professor, Department of Orthopedics and Traumatology, Universidade Federal de São Paulo (Unifesp), São Paulo, Brazil.

References

Benneker LM, Heini PF, Anderson SE, Alini M, Ito K. Correlation of radiographic and MRI pa- rameters to morphological and biochemical assessment of intervertebral disc degeneration. Eur Spine J. 2005;14(1):27-35.

Andersson GB. Epidemiology of low back pain. Acta Orthop Scand Suppl. 1998;281: 28-31.

Battié MC, Videman T, Parent E. Lumbar disc degeneration: epidemiology and genetic in- fluences. Spine (Phila Pa 1976). 2004;29(23):2679-90.

Peterson CK, Bolton JE, Wood AR. A cross-sectional study correlating lumbar spine degene- ration with disability and pain. Spine (Phila Pa 1976). 2000;25(2):218-23.

Luoma K, Riihimäki H, Luukkonen R, Raininko R, Viikari-Juntura E, Lamminen A. Low back pain in relation to lumbar disc degeneration. Spine (Phila Pa 1976). 2000;25(4):487-92.

Urban JPG, Roberts S. The intervertebral disc: normal, aging and pathologic. In: Herkowitz H, Garfin SR, Eismont FJ, Bell GR, Balderston RA, editors. Rothman-Simeone the spine. 5th ed. Philadelphia: Saunders; 2006. p. 71-83.

Modic MT, Masaryk TJ, Ross JS, Carter JR. Imaging of degenerative disk disease. Radiology. 1988;168(1):177-86.

Pfirrmann CW, Metzdorf A, Zanetti M, Hodler J, Boss N. Magnetic resonance classification of lumbar intervertebral disc degeneration. Spine (Phila Pa 1976). 2001;26(17):1873-8.

Southern EP, Fye MA, Panjabi MM, Patel TC, Cholewicki J. Disc degeneration: a human ca- daveric study correlating magnetic resonance imaging and quantitative discomanometry. Spine (Phila Pa 1976). 2000;25(17):2171-5.

Thompson JP, Pearce RH, Schechter MT, Adams ME, Tsang IK, Bishop PB. Preliminary evalu- ation of a scheme for grading the gross morphology of the human intervertebral disc. Spine (Phila Pa 1976). 1990;15(5):411-5.

Griffith JF, Wang YX, Antonio GE, et al. Modified Pfirrmann grading system for lumbar interver- tebral disc degeneration. Spine (Phila Pa 1976). 2007;32(24):E708-12.

Thalgott JS, Albert TJ, Vaccaro AR, et al. A new classification system for degenerative disc disease of the lumbar spine based on magnetic resonance imaging, provocative dis- cography, plain radiographs and anatomic considerations. Spine J. 2004;4(6 Suppl): 167S-172S.

Rillardon L, Campana S, Mitton D, Skalli W, Feydy A. Analyse de l’espace intervertébral avec un système de radiographie basse dose [Evaluation of the intervertebral disc spaces with a low dose radiographic system]. J Radiol. 2005;86(3):311-9.

Dabbs VM, Dabbs LG. Correlation between disc height narrowing and low-back pain. Spine (Phila Pa 1976). 1990;15(12):1366-9.

Pope MH, Hanley E, Matteri RE, Wilder DG, Frymoyer JW. Measurement of intervertebral disc space height. Spine. 1977;2(4):282-86. Available from: http://journals.lww.com/ spinejournal/Abstract/1977/12000/Measurement_of_Intervertebral_Disc_Space_Height.7.aspx. Accessed in 2010 (Feb 2).

Oliveira VM, Puertas EB, Alves MTS, et al. Estudo das terminações nervosas dos discos in- tervertebrais da coluna lombar de humanos [Study of nerve endings of intervertebral discs in the human lumbar spine]. Rev Bras Ortop. 2002;37(5):195-200.

Roberts S, Eisenstein SM, Menage J, Evans EH, Ashton IK. Mechanoreceptors in inter- vertebral discs. Morphology, distribution, and neuropeptides. Spine (Phila Pa 1976). 1995;20(24):2645-51.

Roberts S, Evans H, Trivedi J, Menage J. Histology and pathology of the human intervertebral disc. J Bone Joint Surg Am. 2006;88(Suppl 2):10-4.

Farfan HF. Mechanical disorders of the low back. Philadelphia: Lea and Febiger; 1973.

Freeman MA, Wyke B. The innervation of the knee joint. An anatomical and histological study in the cat. J Anat. 1967;101(Pt 3):505-32.

Adams MA, Roughley PJ. What is intervertebral disc degeneration, and what causes it? Spine (Phila Pa 1976). 2006;31(18):2151-61.

Schiebler ML, Camerino VJ, Fallon MD, Zlatkin MB, Grenier N, Kressel HY. In vivo and ex vivo magnetic resonance imaging evaluation of early disc degeneration with histopathologic correlation. Spine (Phila Pa 1976). 1991;16(6):635-40.

Tertti M, Paajanen H, Laato M, Aho H, Komu M, Kormano M. Disc degeneration in magnetic resonance imaging. A comparative biochemical, histologic, and radiologic study in cadaver spines. Spine (Phila Pa 1976). 1991;16(6):629-34.

Videman T, Battié MC, Gibbons LE, Maravilla K, Manninen H, Kaprio J. Associations between back pain history and lumbar MRI findings. Spine (Phila Pa 1976). 2003;28(6):582-8.

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Published

2010-03-03

How to Cite

1.
Martins DE, Oliveira VM de, Alves MT de S, Wajchenberg M, Landim Élcio, Belloti JC, Puertas EB, Ishida A. Correlations between radiographic, magnetic resonance and histological examinations on the degeneration of human lumbar intervertebral discs. Sao Paulo Med J [Internet]. 2010 Mar. 3 [cited 2025 Mar. 17];128(2):63-8. Available from: https://periodicosapm.emnuvens.com.br/spmj/article/view/1731

Issue

Vol. 128 No. 2 (2010)

Section

Original Article

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