Degenerative disc disease (DDD) is the primary cause of low back pain. The most important factor in the development of DDD is the vertical load force on the disc, increasing the hydrostatic pressure and facilitating discs degenerations. One of the most common conditions accompanying DDD is segmental instability of the spine. The pathogenesis evolves in three phases characterized by a progressive disc dehydration and loss of the disc height. This phenomenon can be observed in magnetic resonance imaging (T2 weighted MRI) as a decrease of the water signal inside the intervertebral disc. It is considered as an indirect sign of the alteration of the composition (including glycosaminoglycans) and the structure of the intervertebral disk with, as consequence, a modification of the spine biomechanics. Animal studies showed that disc regeneration could be enhanced by a decrease of the hydrostatic pressure. This could be observed as a signal increase on T2 weighted MRI. Recent quantitative MRI sequences now allow the quantification of glycosaminoglycans (GAG) concentration inside the cartilage and in the intervertebral disc. The actual surgical trends are in favor of an anterior (intersomatic) vertebrak fusion, associated or not with a posterior fusion. These technics sacrifice the intervertebral disc and change the spine biomechanics. Based on a pilot study, the investigators believe that the conservation and even a regeneration of the intervertebral disc is possible and allows the preservation of the spine biomechanics. The purpose of the study is to analyze the relations between specific MRI signals, the GAGs concentration, and the functional outcome before and after the surgical treatment.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
DIAGNOSTIC
Masking
NONE
Enrollment
40
Specific MRI sequences (delayed gadolinium-enhanced magnetic resonance imaging of cartilage -dGEMRIC) performed before the surgery, 6 months and 1 year after surgery will allow to measure the following parameters: disc height, total lumbar spine lenght, GAGs concentration.
CHU Brugmann
Brussels, Belgium
Gycosaminoglycan (GAG) concentration of the intervertebral disk
GAG concentration is estimated using the delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC) technique
Time frame: Baseline: before surgery
Gycosaminoglycan (GAG) concentration of the intervertebral disk
GAG concentration is estimated using the delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC) technique
Time frame: Six months after surgery
Gycosaminoglycan (GAG) concentration of the intervertebral disk
GAG concentration is estimated using the delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC) technique
Time frame: 1 year after surgery
Disc height
Will be measured using the delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC) technique
Time frame: Baseline: before surgery
Disc height
Will be measured using the delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC) technique
Time frame: Six months after surgery
Disc height
Will be measured using the delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC) technique
Time frame: 1 year after surgery
Total lumbar spine length
Will be measured using the delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC) technique
Time frame: Baseline: before surgery
Total lumbar spine length
Will be measured using the delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC) technique
Time frame: Six months after surgery
Total lumbar spine length
Will be measured using the delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC) technique
Time frame: 1 year after surgery
Lumbar lordosis angle
Will be measured by the EOS imaging system.
Time frame: Baseline: before surgery
Lumbar lordosis angle
Will be measured by the EOS imaging system.
Time frame: Six months after surgery
Lumbar lordosis angle
Will be measured by the EOS imaging system.
Time frame: 1 year after surgery
Oswestry Disability Index (ODI)
Estimation of the functional state of the patient by the Oswestry Disability questionnaire.
Time frame: Baseline: before surgery
Oswestry Disability Index (ODI)
Estimation of the functional state of the patient by the Oswestry Disability questionnaire.
Time frame: Six months after surgery
Oswestry Disability Index (ODI)
Estimation of the functional state of the patient by the Oswestry Disability questionnaire.
Time frame: 1 year after surgery
SF-36
Estimation of the functional state of the patient by the SF-36 questionnaire relative to the quality of life.
Time frame: Baseline: before surgery
SF-36
Estimation of the functional state of the patient by the SF-36 questionnaire relative to the quality of life.
Time frame: Six months after surgery
SF-36
Estimation of the functional state of the patient by the SF-36 questionnaire relative to the quality of life.
Time frame: 1 year after surgery
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