title: Auto fluorescence of intervertebral disc tissue: a new diagnostic tool.
abstract: The paper reports on auto fluorescence phenomena of inter-vertebral human discs. It systematically investigates the auto fluorescence effects of ex vivo disc specimen and reports on surgical cases to demonstrate the potential value of the new method. The paper offers biologic explanations of the phenomenon and discusses the potential value of the UV auto fluorescence technique as a diagnostic tool. Intra- and postoperative observations are made by a surgical microscope with an integrated UV light source. Quantitative measurements were carried out using a photon counter and a spectrometer ex vivo. The auto fluorescence phenomenon allows the differentiation of traumatized and degenerated disc tissue intraoperatively in some cases, it allows the differentiation of bony and collagen endplate in cervical disc surgery. The source of the auto fluorescent light emission are amino acids of the collagen molecules. The proteoglycan components and the liquid components of the disc do not show relevant auto fluorescence. Emission wavelength of disc material is equivalent to color perception. It differs due to different collagen composition of the intervertebral disc components from yellow-green to blue-green and can be visualized in situ by naked eye.UV-auto fluorescence of inter-vertebral discs is a new clinical tool that has the potential to differentiate disc material from the anatomical surrounding, to distinguish between different fractions of the disc and to give information on the quality and status of the disc material. Since the technology has just emerged, it needs further investigations to quantify the clinical observations reported in this paper.
authors.affiliation: Department of Spine Surgery, Mittelbaden Hospital, Robert-Koch-Strasse 70, 77815, Bühl, Baden-Baden, Germany. hoell@klinikum-mittelbaden.de
authors.forename: T
authors.initials: T
authors.lastname: Hoell
authors.forename: G
authors.initials: G
authors.lastname: Huschak
authors.forename: A
authors.initials: A
authors.lastname: Beier
authors.forename: G
authors.initials: G
authors.lastname: Hüttmann
authors.forename: Y
authors.initials: Y
authors.lastname: Minkus
authors.forename: H J
authors.initials: HJ
authors.lastname: Holzhausen
authors.forename: H J
authors.initials: HJ
authors.lastname: Meisel
mesh_terms: D000596:Amino Acids / Q000737:chemistry; D002452:Cell Count; D003094:Collagen / Q000737:chemistry*; D005453:Fluorescence; D006801:Humans; D007403:Intervertebral Disc / Q000033:anatomy & histology* / Q000737:chemistry / Q000473:pathology*; D007405:Intervertebral Disc Displacement / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery; D008159:Lumbar Vertebrae / Q000033:anatomy & histology / Q000737:chemistry / Q000473:pathology; D011237:Predictive Value of Tests; D013125:Spinal Neoplasms / Q000175:diagnosis
chemical_list: D000596:Amino Acids; D003094:Collagen