Previously reported experiments used 11T HR‐MAS Spectroscopy to examine discs removed at surgery. Lactic acid (LA) and proteoglycan (PG), appeared to be quantifiable markers for discogenic pain. The goal of this study is to acquire magnetic resonance spectroscopy (MRS) signatures of the intervertebral disc in vivo (DDD‐MRS), and to correlate these with other standard diagnostic measures.
65 discs from 36 total subjects from a single center were included. Thirty‐eight discs were from 17 patients with a diagnosis of chronic low back pain, and 27 discs were from 19 asymptomatic volunteers (ASY). All discs were evaluated by single voxel magnetic resonance spectroscopy (SV‐MRS). Thirteen discography positive (PD+) discs were used as positive control (PC) discs, and 12 discography negative (PD‐) discs plus all the ASY discs were used as negative control (NC) discs.
PD was performed when indicated. A 3.0T GE Signa MRI system and 8‐channel spine detector coil were used with the DDD‐MRS. Multi‐variate regression analyses produced a DDD‐MRS diagnostic algorithm using PG, LA, and alanine (AL) MRS region data to calculate a single number for a disc. Positive numbers were MRS+ (painful), and negative values were MRS‐ (non‐painful).
DDD‐MRS diagnoses demonstrated a strong correlation with the clinical diagnoses (R2=.89, p
The DDD‐MRS diagnostic algorithm developed and evaluated in this study demonstrated high sensitivity for identifying discs with discogenic pain, and a high specificity for identifying non‐painful levels. Further prospective, multi‐center studies are warranted to confirm these encouraging results.