Fulltext

Degeneration of the cervical disc: histology compared with radiography and magnetic resonance imaging

Christe, A. ; Läubli, R. ; Guzman, R. ; Berlemann, U. ; Moore, R. ; Schroth, G. ; Vock, P. ; Lövblad, K.

In: Neuroradiology, 2005, vol. 47, no. 10, p. 721-729

Ajouter à la liste personnelle
    Titre
    • Degeneration of the cervical disc: histology compared with radiography and magnetic resonance imaging
    Auteur
    • Christe, A.. Department of Radiology, Inselspital, University of Berne, Berne, Switzerland
    • Läubli, R.. Department of Orthopaedic Surgery, Inselspital, University of Berne, Berne, Switzerland
    • Guzman, R.. Department of Neuroradiology, Inselspital, University of Berne, Berne, Switzerland
    • Berlemann, U.. Department of Orthopaedic Surgery, Inselspital, University of Berne, Berne, Switzerland
    • Moore, R.. Institute of Medical and Veterinary Science, Adelaide, South Australia
    • Schroth, G.. Department of Neuroradiology, Inselspital, University of Berne, Berne, Switzerland
    • Vock, P.. Department of Radiology, Inselspital, University of Berne, Berne, Switzerland
    • Lövblad, K.. Department of Neuroradiology, Inselspital, University of Berne, Berne, Switzerland
    Type de document
    • Postprint
    Langue
    • Anglais
    Publié dans
    • Neuroradiology, 2005, vol. 47, no. 10, p. 721-729. Springer-Verlag; http://www.springer.de
    Autre version électronique
    Identifiant OAI-PMH
    • oai:doc.rero.ch:310763
    Summary
    Decisions about the treatment of neck pain are largely made on the basis of information gained from plain X-rays and magnetic resonance imaging (MRI), which are used routinely as part of preliminary investigation. We performed a descriptive cadaveric study to compare histology with radiography and MRI. We correlated plain radiography, disc height [Farfan index (FI)] and MRI findings with histology to assess the ability of radiology to detect significant pathologic lesions. The study included 52 motion segments from nine subjects over the age of 50, who underwent routine hospital autopsy. Disc degeneration was assessed by histology, radiography, disc height (FI: anterior disc height plus posterior disc height divided by anterioposterior diameter) and MRI using established grading systems. Most of the discs were classified radiologically as grade 1 (19/52), grade 2 (13/52), grade 3 (9/52) or grade 4 (3/52). Eight of the discs were graded as normal. The distribution of MRI grades was grade 0 (9/36), grade 1 (9/36), grade 2 (7/36), grade 3 (8/36) and grade 4 (3/36). Half of the discs (26/52) showed advanced (grade 4) degeneration histologically. FI correlated with histological grade (P=0.013), MRI grade (P=0.02) and radiological grade (P<0.001) of degeneration. Radiological and histological grade of degeneration showed a weak correlation (r=0.3, P=0.033). MRI correlated with overall histological grade (r=0.41, P=0.015, n=34). Histological features (e.g., tears, rim lesions, prolapse of nucleus material) were poorly recognised by MRI, which had a sensitivity for disc material prolapse and annulus tears of less than 40%. Our study showed that discs from patients over 50years are histologically severely degenerated; however, these changes may not be detected by conventional radiography and MRI