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MRI Phenotypes of Herniated Discs Associated with Adjacent Disc Degeneration – Lumbar Fusion

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Adjacent segment degeneration (ASD) is a commonly observed complication in patients after fusion surgery. A new study aimed to assess and compare the MRI spinal phenotype of herniated levels with and without adjacent disc degeneration (ADD) in order to understand the pathological process and prognosis post-surgery. The study analyzed pre-operative T2W sagittal lumbar MRI images of 155 lumbar disc herniated patients and found that ADD was present in 57% of the patients. Vertebral endplate (VEP) defects were significantly higher in levels with ADD, and patients with ADD had higher VEP defect scores, Modic scores, high intensity zone (HIZ) scores, and posterior bulge scores. The study suggests that levels with VEP defects and severe grade of disc herniation are more likely to develop ADD, which can also affect other spinal levels and postoperative prognosis

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
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Published article

Adjacent segment degeneration is commonly observed in patients after fusion surgery. Among the associated risk factors is the pre-operative presence of adjacent disc degeneration (ADD). The risk factors and other spine phenotypes associated with pre-operative ADD is critical to understand the pathological process and better prognosis post-surgery. Current study aims to assess and compare the MRI spinal phenotype of herniated level with and without adjacent disc degeneration (ADD). Pre-operative…

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J Orthop Res. 2023 Nov 17. doi: 10.1002/jor.25739. Online ahead of print.ABSTRACTAdjacent segment degeneration is commonly observed in patients after fusion surgery. Among the associated risk factors is the pre-operative presence of adjacent disc degeneration (ADD). The risk factors and other spine phenotypes associated with pre-operative ADD is critical to understand the pathological process and,

J Orthop Res. 2023 Nov 17. doi: 10.1002/jor.25739. Online ahead of print.

ABSTRACT

Adjacent segment degeneration is commonly observed in patients after fusion surgery. Among the associated risk factors is the pre-operative presence of adjacent disc degeneration (ADD). The risk factors and other spine phenotypes associated with pre-operative ADD is critical to understand the pathological process and better prognosis post-surgery. Current study aims to assess and compare the MRI spinal phenotype of herniated level with and without adjacent disc degeneration (ADD). Pre-operative T2W sagittal lumbar MRI images of 155 lumbar disc herniated patients were analyzed for the presence of ADD (Pfirrmann grade III and above). The herniated disc level was assessed for the presence and absence of vertebral endplate (VEP) defects, Modic changes, and high intensity zone (HIZ). Mean age of patients was 38±2 years, almost 62% were males. ADD was found in 57%, VEP defects were seen in 62% of the herniated level, 24.5% showed Modic changes, 3.8 % showed spondylolishthesis and 15.5% revealed HIZ. Age and other demographic factors did not have any significant effect on the presence of ADD, the patients with extruded & sequestered discs had more ADD (p=0.02). VEP defects were significantly higher in levels with ADD (p=0.02). Patients with ADD had significantly VEP defect scores (p=0.01), Modic score (p=0.002), HIZ score (0.02) & posterior bulge score (p<0.001). Findings suggest that affected levels with VEP defects & severe grade of disc herniation have the greater likelihood of having ADD. Once developed this ADD may also affect the other spinal levels, and also can affect postoperative prognosis. This article is protected by copyright. All rights reserved.

PMID:37975261 | DOI:10.1002/jor.25739

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MRI Phenotypes of Herniated Discs Associated with Adjacent Disc Degeneration

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J Orthop Res. 2023 Nov 17. doi: 10.1002/jor.25739. Online ahead of print.ABSTRACTAdjacent segment degeneration is commonly observed in patients after fusion surgery. Among the associated risk factors is the pre-operative presence of adjacent disc degeneration (ADD). The risk factors and other spine phenotypes associated with pre-operative ADD is critical to understand the pathological process and

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