Low back pain is a multi-factorial disease with high socioeconomic cost. Conditions including degeneration of intervertebral discs (IVD), pathology of vertebral body, and fracture of vertebral endplate all are closely associated with low back pain. Disco-vertebral junction is the interface between the IVD and vertebral body, and plays important roles in nutrition of the IVD via vascular canals in the adjacent vertebral body, as well as in biomechanical support during loading. Abnormal changes in structure, composition and function of the DVJ may occur in diseases and aging, which may hinder nutrient transport and lead to IVD degeneration, as well as degeneration of the vertebral body. The long-term goal of this study is to establish a non-invasive imaging technique for a comprehensive evaluation of the whole lumbar spine. While magnetic resonance imaging (MRI) has been used routinely, conventional MR techniques such as spin echo sequence are unable to detect sufficient MR signal from the DVJ, and little is known about MR characteristics of the region. We have recently shown in that Ultrashort Time-to-Echo (UTE) MRI, but not conventional MRI, is able to evaluate the DVJ directly in human lumbar spines. As the next step, we seek to determine if UTE MRI can detect abnormal and pathologic changes in structure, composition, transport-function the DVJ, which may be related to degeneration of the IVD and vertebral body. Finally, we seek to translate the techniques to evaluate the DVJ, IVD, and vertebral body in normal and low back pain human subjects. This study will establish the foundation and rationale for UTE MR evaluation of the DVJ, and help to better understand pathoetiology of disc degeneration.
This study proposes to implement Ultrashort Time to Echo (UTE) MR techniques to evaluate the structure, composition, and function of disco-vertebral junction in human lumbar spines, associate finding with degenerative changes of the adjacent disc and vertebral body, and translate the techniques to human subjects.
