Correlations between radiographic, magnetic resonance and histological examinations on the degeneration of human lumbar intervertebral discs.
OBJECTIVE
There is controversy regarding which imaging method is best for identifying early degenerative alterations in intervertebral discs. No correlations between such methods and histological finds are presented in the literature. The aim of this study was to correlate the thickness of intervertebral discs measured on simple radiographs with the degree of degeneration seen on magnetic resonance images and the histological findings relating to nerve ends inside the discs.


METHODS
Cross-sectional correlation study on the lumbar spines of human cadavers, at Universidade Federal de São Paulo (Unifesp), São Paulo, Brazil.


METHODS
Ten lumbar spinal columns were extracted from human cadavers and subjected to magnetic resonance imaging and simple radiography. They were classified according to the degree of disc degeneration seen on magnetic resonance, and the thickness of the discs was measured on radiographs. The intervertebral discs were then extracted, embedded in paraffin and analyzed immunohistochemically with protein S100, and the nerve fibers were counted and classified.


RESULTS
No correlation was observed between the thickness of the intervertebral discs and the degree of degeneration seen on magnetic resonance images. Only the uppermost lumbar discs (L1/L2 and L2/L3) presented a correlation between their thickness and type I and IV nerve endings.


CONCLUSIONS
Reduced disc thickness is unrelated to increased presence of nerve ends in intervertebral discs, or to the degree of disc degeneration.
Martins
Delio Eulalio
DE
Department of Orthopedics and Traumatology, Universidade Federal de São Paulo, São Paulo, Brazil. eulalio@mac.com
Oliveira
Valdeci Manoel de
VM
Alves
Maria Teresa de Seixas
MT
Wajchenberg
Marcelo
M
Landim
Elcio
E
Belloti
João Carlos
JC
Puertas
Eduardo Barros
EB
Ishida
Akira
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002102:Cadaver; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D055959:Intervertebral Disc Degeneration / Q000000981:diagnostic imaging* / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009412:Nerve Fibers / Q000000981:diagnostic imaging / Q000473:pathology*; D011859:Radiography; D009418:S100 Proteins / Q000032:analysis*
D009418:S100 Proteins