VOLUMETRIC ASSESSMENT OF INTERVERTEBRAL DISCS IS THE BASIS FOR THE STRATIFICATION OF DEGENERATIVE SPINE PATHOLOGY

Relevance. Intervertebral disc degeneration is a natural process of involutional changes that, in some cases, progresses rapidly and intensely, becoming pathological and accompanied by pain. It is one of the most common causes of disability. Existing methods for visually assessing intervertebral disc degeneration are subjective and dependent on the power of the magnetic resonance imaging scanner.

Aim: to develop a unified quantitative method for assessing intervertebral disc degeneration.

Materials and methods. A prospective, single-center study was conducted involving 20 patients (60 discs) diagnosed with lumbar dorsopathy. Magnetic resonance imaging was performed in DWI mode with the calculation of the degeneration coefficient (X) as the ratio of the measured diffusion coefficient of the nucleus pulposus to the measured diffusion coefficient of the cerebrospinal fluid.

Results. When comparing the obtained X-factor values ​​for degeneration of 60 intervertebral discs with the Pfirrmann classification, degenerated discs had an X-factor value less than 0.8, while no signs of degeneration were detected with an X-factor value greater than 0.8. Consequently, the lower the X-factor value, the more severe the degeneration. A comparison of the obtained values ​​did not reveal a direct correlation, due to the subjective nature of signal intensity assessment in T2 mode during magnetic resonance imaging.

Conclusions. The X degeneration coefficient is an objective, reproducible parameter independent of tomograph power and suitable for pathology stratification and dynamic monitoring.  The proposed method enables quantitative assessment of degenerative changes. The obtained results confirm the fundamental viability and advantages of the proposed degeneration coefficient X. A promising direction for its full validation and implementation in clinical practice is multicenter studies on an expanded cohort of patients.

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