MRI-biochemical follow up measurements of lumbar intervertebral disc in patients with leg length discrepancy: Is it possible to alter cartilage damage with conservative therapy?

Miriam Frenken; David Latz; Erik Schiffner; Wolfgang Alois Quante; Maxime Knautz; Daniel Benjamin Abrar; Benedikt Schaarschmidt; Christoph Schleich

doi:10.1016/j.jor.2019.06.006

MRI-biochemical follow up measurements of lumbar intervertebral disc in patients with leg length discrepancy: Is it possible to alter cartilage damage with conservative therapy?

J Orthop. 2019 Jun 4;16(6):473-477. doi: 10.1016/j.jor.2019.06.006. eCollection 2019 Nov-Dec.

Authors

Miriam Frenken¹, David Latz², Erik Schiffner², Wolfgang Alois Quante², Maxime Knautz¹, Daniel Benjamin Abrar¹, Benedikt Schaarschmidt¹, Christoph Schleich¹

Affiliations

¹ Department for Diagnostic and Interventional Radiology and University Hospital Dusseldorf, Heinrich-Heine-University, Dusseldorf, Germany.
² Department of Trauma and Hand Surgery, University Hospital Dusseldorf, Heinrich-Heine-University, Dusseldorf, Germany.

Abstract

Objective: Effect of conservative therapy on intervertebral discs (IVD) in patients with leg-length-discrepancy (LLD).

M&m: Seventy lumbar IVDs of 14 participants (five with LLD 10-20 mm) were examined using a 3T-MRI-scanner. Morphological (Pfirrmann) and molecular (glycosaminoglycan-chemical-exchange-saturation-transfer, gagCEST) grading was assessed before and after a four-month therapy (physiotherapy and shoe inlays).

Results: Significantly lower GAG values in patients with LLD were found (L5/S1, p = 0.02). After therapy, a trend towards higher gagCEST values in patients with LLD was observed (2.48 ± 1.77% vs. 1.79 ± 0.79%; p > 0.05).

Conclusion: LLD represents a risk factor for molecular alterations of lumbar IVDs. Only minor effects of conservative therapy on these alterations could be found.

Keywords: Contrast-free MRI; Follow-up analysis; GagCEST; Leg length discrepancy; Lumbar spine; Molecular MRI; Molecular imaging.