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. 2019 Apr 8;16(5):363-367.
doi: 10.1016/j.jor.2019.03.014. eCollection 2019 Sep-Oct.

Assessment of glycosaminoglycan content in intervertebral discs of patients with leg length discrepancy: A pilot study

David Latz  1 , Miriam Frenken  2 , Erik Schiffner  1 , Maxime Knautz  2 , Wolfgang Alois Quante  1 , Joachim Windolf  1 , Jan Peter Grassmann  1 , Pascal Jungbluth  1 , Christoph Schleich  2
Affiliations

Assessment of glycosaminoglycan content in intervertebral discs of patients with leg length discrepancy: A pilot study

David Latz et al. J Orthop. .

Abstract

Objective: Leg length discrepancy (LLD) could be a predisposing factor for early degeneration of lumbar intervertebral discs (IVD). The purpose of this study was to elucidate the molecular effect of LLD on IVDs.

Methods: IVDs of Eleven patients (25.6 ± 4.3years) with LLD (>10 mm) and 14 control subjects (23.9 ± 3.5years) were compared using a 3T-MR scanner. Morphological T2-weighted and glycosaminoglycan-chemical-exchange-saturation-transfer (gagCEST) sequences were performed.

Results: No differences in morphological Pfirrmann grading were found (p > 0.05). In contrast, nucleus-pulposus-gagCEST-values of L5/S1 were significantly lower (p = 0.0008).

Conclusion: Our results suggest that LLD is a predisposing factor for molecular IVD alterations, which are detectable even before morphological pathologies could be found.

Keywords: Chemical exchange saturation transfer (CEST); Glycosaminoglycan (GAG); Intervertebral disc degeneration; Leg length discrepancy; Magnetic resonance imaging (MRI); Preventive medicine.

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Figures

Fig. 1
Fig. 1
Comparison of NP-gagCEST values of L5/S1 IVD between patients with LLD >10 mm and control subjects.
Fig. 2
Fig. 2
Color-coded gagCEST map with high GAG content in blue and low GAG content in red of the lumbar spine (L1–S1). On the left side, a participant without leg length discrepancy (LLD) with high GAG content (blue IVDs), and on the right side, a patient with LLD demonstrating molecular alteration of the lumbar disc on level L5/S1 with low GAG content in red and orange. Pfirrmann grading illustrates no morphological disc degeneration with scores of 1 or 2.
Fig. 3
Fig. 3
Color-coded gagCEST map with high GAG content in blue and low GAG content in red of the lumbar spine (L1–S1). Another example of a participant without LLD on the left side compared to a patient with LDD on the right side. On level L5/S1, the patient with LLD (right side) showed significantly lower GAG content compared to control participant. All discs revealed no morphological disc degeneration with Pfirrmann score 1 or 2 (not shown in this picture).
See this image and copyright information in PMC

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