title: Human intervertebral disc stiffness correlates better with the Otsu threshold computed from axial T2 map of its posterior annulus fibrosus than with clinical classifications.
abstract: Degeneration of the intervertebral disc, sometimes associated with low back pain and abnormal spinal motions, represents a major health issue with high costs. A non-invasive degeneration assessment via qualitative or quantitative MRI (magnetic resonance imaging) is possible, yet, no relation between mechanical properties and T2 maps of the intervertebral disc (IVD) has been considered, albeit T2 relaxation time values quantify the degree of degeneration. Therefore, MRI scans and mechanical tests were performed on 14 human lumbar intervertebral segments freed from posterior elements and all soft tissues excluding the IVD. Degeneration was evaluated in each specimen using morphological criteria, qualitative T2 weighted images and quantitative axial T2 map data and stiffness was calculated from the load-deflection curves of in vitro compression, torsion, lateral bending and flexion/extension tests. In addition to mean T2, the OTSU threshold of T2 (TOTSU), a robust and automatic histogram-based method that computes the optimal threshold maximizing the distinction of two classes of values, was calculated for anterior, posterior, left and right regions of each annulus fibrosus (AF). While mean T2 and degeneration schemes were not related to the IVDs' mechanical properties, TOTSU computed in the posterior AF correlated significantly with those classifications as well as with all stiffness values. TOTSU should therefore be included in future degeneration grading schemes.
authors.affiliation: Institute of Surgical Technology and Biomechanics, University of Berne, Switzerland.
authors.forename: Ghislain
authors.initials: G
authors.lastname: Maquer
authors.affiliation: Department of Clinical Research, University of Berne, Switzerland.
authors.forename: Vaclav
authors.initials: V
authors.lastname: Brandejsky
authors.affiliation: Department of Orthopaedic Surgery, Inselspital, University of Berne, Switzerland.
authors.forename: Lorin M
authors.initials: LM
authors.lastname: Benneker
authors.affiliation: Department of Orthopaedic Surgery, Teikyo University, Ichihara, Japan.
authors.forename: Atsuya
authors.initials: A
authors.lastname: Watanabe
authors.affiliation: Department of Clinical Research, University of Berne, Switzerland.
authors.forename: Peter
authors.initials: P
authors.lastname: Vermathen
authors.affiliation: Institute of Surgical Technology and Biomechanics, University of Berne, Switzerland. Electronic address: philippe.zysset@istb.unibe.ch.
authors.forename: Philippe K
authors.initials: PK
authors.lastname: Zysset
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001696:Biomechanical Phenomena; D006801:Humans; D007403:Intervertebral Disc; D055959:Intervertebral Disc Degeneration / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging; D008422:Materials Testing; D055595:Mechanical Phenomena; D008875:Middle Aged
keywords: Axial T(2) maps; Degeneration grade; Experimental stiffness; Human intervertebral disc; MRI