title: Microscopic assessment of degenerated intervertebral disc: clinical implications and possible therapeutic challenge.
abstract: OBJECTIVE
  To investigate a possible correlation between the histological and morphometric properties of herniated intervertebral disc, clinical and magnetic resonance imaging (MRI) characteristics of patients with lumbar disc degeneration (LDD).
  
  
  METHODS
  Thirty six patients with LDD were clinically evaluated using Japanese Orthopaedic Association Score (JOAS), visual analogue scale (VAS) for pain in the lower back or in the pelvic limb; MRI-based classification according to Pfirrmann and Modic criteria. All patients underwent decompressive surgery and herniated intervertebral disc samples were histologically and morphometrically analyzed. Data obtained were statistically analyzed for bivariate and partial correlations.
  
  
  RESULTS
  The mean area size of chondron clusters correlated with age, JOAS (r=-0.385, p=0.032, tau=-0.279, rho=-0.380), Pfirrmann (r=0.505, p=0.002, tau=0.289, rho=0.365) and Modic (r=0.500, p=0.002, tau=0.331, rho=0.419) grading. There was a strong correlation between maximum area size of chondrons and JOAS (r=-0.427, p=0.009, tau=-0.299, rho=-0.430), Pfirrmann changes (r=0.432, p=0.008, tau=0.309, rho=0.388) and Modic endplate changes (r=0.444, p=0.007, tau=0.343, rho=0.434). JOAS correlated with both MRI classifications used for LDD.
  
  
  CONCLUSIONS
  The intervertebral disc cells tend to aggregate in clusters and the size of the chondrons from LDD correlated with JOAS, Pfirrmann and Modic. JOAS correlates with the imagistic evaluation systems Pfirrmann and Modic.
authors.affiliation: Second Department of Orthopedics, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania.
authors.forename: Manuel
authors.initials: M
authors.lastname: Oprea
authors.affiliation: Second Department of Orthopedics, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania.
authors.forename: Iulian
authors.initials: I
authors.lastname: Popa
authors.affiliation: Department of Morphologic Microscopy/Histology, Angiogenesis Research Center, "Victor Babes" University of Medicine and Pharmacy Timisoara, Romania ancacimpean1972@yahoo.com acimpeanu@umft.ro.
authors.forename: Anca Maria
authors.initials: AM
authors.lastname: Cimpean
authors.affiliation: Department of Morphologic Microscopy/Histology, Angiogenesis Research Center, "Victor Babes" University of Medicine and Pharmacy Timisoara, Romania.
authors.forename: Marius
authors.initials: M
authors.lastname: Raica
authors.affiliation: Second Department of Orthopedics, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania.
authors.forename: Dan V
authors.initials: DV
authors.lastname: Poenaru
mesh_terms: D000328:Adult; D001706:Biopsy; D005260:Female; D006801:Humans; D007403:Intervertebral Disc / Q000473:pathology*; D055959:Intervertebral Disc Degeneration / Q000175:diagnosis / Q000473:pathology* / Q000628:therapy; D008279:Magnetic Resonance Imaging; D008297:Male; D008853:Microscopy / Q000379:methods*; D008875:Middle Aged; D055815:Young Adult
keywords: Intervertebral disc degeneration; Modic grading; Pfirrmann grading; chondron; histology; morphometry