Lumbar disc herniation: Is there an association between histological and magnetic
resonance imaging findings?
#MMPMID27293282
Majeed SA
; Seshadrinath NA
; Binoy KR
; Raji L
Indian J Orthop
2016[May]; 50
(3
): 234-42
PMID27293282
show ga
BACKGROUND: Although validated radiological scoring systems and histological
scoring system of surgically removed degenerated disc are used in assessment of
progression of intervertebral disc degeneration, there have not been many studies
that integrate these two aspects of assessments. The data available in this
respect are very limited. This clinical study was designed to find the
correlation between quantitative radiological score (Pfirmann grading system and
Modic changes [MC]) and quantitative histological degeneration score (HDS).
MATERIALS AND METHODS: A cohort of 77 patients (45 males, 32 females; mean age of
38 years [range 18-58 years]) who presented with complaints of discogenic pain or
radiculopathy at single level were assessed radiologically. They were graded
according to the radiological pattern. The surgically excised disc specimen was
graded according to HDS. The degree of radiological changes were correlated with
the degree of histological changes. RESULTS: Though the overall HDS (0-15) did
not show statistically significant correlation with Pfirmann grading system,
there were positive association found between mucoid degeneration, chondrocyte
proliferation with the Pfirmann grading and mucoid degeneration, which were
statistically significant. Female sex also had a higher association with
instability pattern. CONCLUSION: The study shows that the Pfirmann grading
system, MCs and HDS can reliably be used as scoring systems for assessing lumbar
disc degeneration. The radiological assessment can be used as a noninvasive tool
to assess the probable change in content rather than the microstructure of a disc
undergoing degeneration.
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