A major focus of this project has been improving the accuracy of interpretation of spine MR and CT by precise anatomic correlations. Progress toward the first objective, a systematic correlation of MR and CT images with sections has been documented in 40 journal articles describing correlations of high resolution axial, coronal and sagittal MR images with cryomicrotomic sections. Important progress has been made toward the second objective: to study the CT and MR appearance of normal developmental and degenerative changes within the spine. The most noteworthy and original observations, on the internal structure of the intervertebral disc visualized with MR, have been reported in a series of papers. These studies have suggested that normal disc degeneration is characterized by gradual increase in collagen in the nucleus and anulus and that degeneration is characterized by a radial tear of the anulus fibrosus, which leads to disc bulging, disc space collapse, or nucleus pulposus herniation. These findings need more study. The third objective, to study changes in spine anatomic relationships as the spine is flexed, extended or loaded, has produced observations in changes in neural foramina, discs, spinal canal as the spine is subjected to various loads. This work will be continued to identify the characteristics of motion segments (intervertebral discs) in which axial loading produces the greatest change in disc or foramen dimension, or produces more compression. Support is requested to continue work that improves the diagnostic value of CT and MR and to study the provocative findings of the first grant period. The new focus of the project is acute degenerative changes in the intervertebral disc including the radial tear of the anulus, herniation of the nucleus pulposus. Cadavers in the 1-49 year age group will be studied. The techniques of cryomicrotomy and MR will also be applied to acute intervertebral disc degeneration, which has been modelled in dogs, by means of a nucleotome. More precise interpretation of CT and MR studies, improved radiographic detection of nerve compression, and betters election of patients for conventional and innovative treatments can be anticipated.

National Institute of Health (NIH)
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
Research Project (R01)
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Diagnostic Radiology Study Section (RNM)
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Medical College of Wisconsin
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Fujiwara, A; An, H S; Lim, T H et al. (2001) Morphologic changes in the lumbar intervertebral foramen due to flexion-extension, lateral bending, and axial rotation: an in vitro anatomic and biomechanical study. Spine (Phila Pa 1976) 26:876-82
Tanaka, N; An, H S; Lim, T H et al. (2001) The relationship between disc degeneration and flexibility of the lumbar spine. Spine J 1:47-56
Fujiwara, A; Lim, T H; An, H S et al. (2000) The effect of disc degeneration and facet joint osteoarthritis on the segmental flexibility of the lumbar spine. Spine (Phila Pa 1976) 25:3036-44
Haughton, V M; Lim, T H; An, H (1999) Intervertebral disk appearance correlated with stiffness of lumbar spinal motion segments. AJNR Am J Neuroradiol 20:1161-5
Schmidt, T A; An, H S; Lim, T H et al. (1998) The stiffness of lumbar spinal motion segments with a high-intensity zone in the anulus fibrosus. Spine (Phila Pa 1976) 23:2167-73
Grogan, J; Nowicki, B H; Schmidt, T A et al. (1997) Lumbar facet joint tropism does not accelerate degeneration of the facet joints. AJNR Am J Neuroradiol 18:1325-9
Yetkin, F Z; Haughton, V M; Cox, R W et al. (1996) Effect of motion outside the field of view on functional MR. AJNR Am J Neuroradiol 17:1005-9
Nowicki, B H; Haughton, V M; Schmidt, T A et al. (1996) Occult lumbar lateral spinal stenosis in neural foramina subjected to physiologic loading. AJNR Am J Neuroradiol 17:1605-14
Inufusa, A; An, H S; Lim, T H et al. (1996) Anatomic changes of the spinal canal and intervertebral foramen associated with flexion-extension movement. Spine (Phila Pa 1976) 21:2412-20
Hasegawa, T; An, H S; Haughton, V M et al. (1995) Lumbar foraminal stenosis: critical heights of the intervertebral discs and foramina. A cryomicrotome study in cadavera. J Bone Joint Surg Am 77:32-8

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