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

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  1 , David Latz  2 , Erik Schiffner  2 , Wolfgang Alois Quante  2 , Maxime Knautz  1 , Daniel Benjamin Abrar  1 , Benedikt Schaarschmidt  1 , Christoph Schleich  1
Affiliations

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 et al. J Orthop. .

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.

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Figures

Fig. 1
Fig. 1
T2-images at baseline of one exemplary patient of the control group (left) and one LLD patient (right). Pfirrmann grading illustrated no morphological disc degeneration with scores of 1 or 2.
Fig. 2
Fig. 2
T2-images at follow up of one patient of the control group (left) and one LLD patient (right).
Fig. 3
Fig. 3
GagCEST map with high GAG content in blue and low GAG content in red of the lumbar spine (L1 - S1) of a control group patient (left) and a LLD-patient (right). Molecular alteration of the lumbar disc on level L5/S1 are demonstrated with low GAG content in red and orange for the LLD-patient. (For interpretation of the references to color in this figure legend, the reader is referred to the Web version of this article.)
Fig. 4
Fig. 4
GagCEST map at follow up of a control group patient (left) and a LLD-patient (right). With rising GagCest values in IVD L5/S1 in LLD patients after therapy, there is no significant difference between control group and LLD patients. (For interpretation of the references to color in this figure legend, the reader is referred to the Web version of this article.)
See this image and copyright information in PMC

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