Dynamic functional nucleus is a potential biomarker for structural degeneration in cervical spine discs.
Dynamic functional nucleus is a potential biomarker for structural degeneration in cervical spine discs.
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动态功能核是颈椎间盘结构退化的潜在生物标志物。
DOI：
10.1002/jor.24252
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发表时间：
2019
期刊：
影响因子：
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通讯作者：
Anderst,WilliamJ
中科院分区：
文献类型：
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作者：
LeVasseur,ClarissaM;Wawrose,Richard;Pitcairn,Samuel;Donaldson,WilliamF;Lee,JoonY;Anderst,WilliamJ
如果椎间盘退变可以及早发现，预防性治疗可以在症状变得致残和昂贵之前开始。椎间盘力学的变化，如髓核压缩模量的降低，是退变的一些最早迹象。因此，椎间盘对压缩载荷的反应的体内变化可以作为即将发生或早期椎间盘退变的生物标志物。本研究的目的是评估使用体内动态椎间盘变形来识别椎间盘病理性结构变性的可能性。经确认的基于模型的跟踪技术确定了颈椎动态屈曲/伸展和轴向旋转期间收集的双平面X线片的椎体运动。开发了轴下椎间盘的计算模型，以识别每个椎间盘的动态功能核，即在动态运动过程中几乎没有额外压缩的椎间盘区域。对10名C5/C6颈椎病患者、10名C5/C6/C7颈椎病患者和10名无症状对照者的动态功能核的大小和位置进行了测定。动态功能核大小对病理性椎间盘退变敏感（在患病椎间盘的6次测量中，有5次显著小于对照组），且具有特异性（在非患病椎间盘的10次测量中，有9次与对照组无差异）。这些结果提供的证据表明，结构性椎间盘退变，表现为功能负荷的椎间盘反应的变化，可以确定在体内从功能运动过程中收集的动态成像。© 2019骨科研究学会。出版社：Wiley Periodicals，Inc. J Orthop Res 9999：1-7，2019.
If intervertebral disc degeneration can be identified early, preventative treatments may be initiated before symptoms become disabling and costly. Changes in disc mechanics, such as the decrease in the compressive modulus of the nucleus, are some of the earliest signs of degeneration. Therefore, in vivo changes in the disc response to compressive load may serve as a biomarker for pending or early disc degeneration. The aim of this study was to assess the potential for using in vivo dynamic disc deformation to identify pathologic structural degeneration of the intervertebral disc. A validated model‐based tracking technique determined vertebral motion from biplane radiographs collected during dynamic flexion/extension and axial rotation of the cervical spine. A computational model of the subaxial intervertebral discs was developed to identify the dynamic functional nucleus of each disc, that is, the disc region that underwent little to no additional compression during dynamic movements. The size and location of the dynamic functional nucleus was determined for 10 C5/C6 spondylosis patients, 10 C5/C6/C7 spondylosis patients, and 10 asymptomatic controls. The dynamic functional nucleus size was sensitive (significantly smaller than controls in 5 of 6 measurements at the diseased disc) and specific (no difference from controls in 9 of 10 measurements at non‐diseased discs) to pathologic disc degeneration. These results provide evidence to suggest that structural disc degeneration, manifested by changes in the disc response to functional loading, may be identified in vivo from dynamic imaging collected during functional movements. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 9999:1–7, 2019.