Degeneration alters the structural components of the disc and its mechanical behavior. Understanding this pathophysiological process is of great importance, as it may lead to back pain. However, non-invasive methods to characterize the disc mechanics in vivo are lacking. Here, a potential method for measurements of the intradiscal deformation under stress is presented. The method utilizes a standard MRI protocol, commercial loading equipment, and registration software. The lumbar spine (L1/L2–L5/S1) of 36 human subjects was imaged with and without axial loading of the spine. The resulting images were registered, and changes in the images during the registration were displayed pixel-by-pixel to visualize the internal deformation of the disc. The degeneration grade, disc height, disc angle and tilt angle were determined and correlated with the deformation using multivariate regression analysis. The largest deformation was found at the lower lumbar spine, and differences in regional behaviors between individual discs were found. Weak to moderate correlations between the deformation and different disc characteristics were found, where the degeneration grade and tilt angle were the main contributing factors. To conclude, the image-based method offers a potential tool to study the pathophysiological process of the disc.
In vivo evaluation of the intervertebral disc (IVD) during spinal loading may yield greater insight into the biomechanical properties of the IVD. This study aimed to investigate how the lumbar IVD deforms during loading, quantified with a novel non-invasive method utilizing MRI and image registration. Findings showed that the intradiscal deformation depends not only on disc degeneration but also on the lumbar spine level. This highlights the need for tools that can evaluate the mechanical properties of the disc in vivo. The proposed method offers a possibility to depict and track biomechanical changes non-invasively while characterizing disc structures in detail.
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