title: Diffusion-Weighted MRI Assessment of Adjacent Disc Degeneration After Thoracolumbar Vertebral Fractures.
abstract: OBJECTIVE
  The purpose of this study was to assess, by the mean apparent diffusion coefficient (ADC), if a relationship exists between disc ADC and MR findings of adjacent disc degeneration after thoracolumbar fractures treated by anatomic reduction using vertebral augmentation (VAP).
  
  
  METHODS
  Twenty non-consecutive patients (mean age 50.7 years; range 45-56) treated because of vertebral fractures, were included in this study. There were 10 A3.1 and 10 A1.2 fractures (AO classification). Surgical treatment using VAP was applied in 14 cases, and conservative in 6 patients. MRI T2-weighted images and mapping of apparent diffusion coefficient (ADC) of the intervertebral disc adjacent to the fractured segment were performed after a mean follow-up of 32 months. A total of 60 discs, 3 per patient, were analysed: infra-adjacent, supra-adjacent and a control disc one level above the supra-adjacent.
  
  
  RESULTS
  No differences between patients surgically treated and those following a conservative protocol regarding the average ADC values obtained in the 20 control discs analysed were found. Considering all discs, average ADC in the supra-adjacent level was lower than in the infra-adjacent (1.35 ± 0.12 vs. 1.53 ± 0.06; p < 0.001). Average ADC values of the discs used as a control were similar to those of the infra-adjacent level (1.54 ± 0.06). Compared to surgically treated patients, discs at the supra-adjacent fracture level showed statistically significant lower values in cases treated conservatively (p < 0.001). The variation in the delay of surgery had no influence on the average values of ADC at any of the measured levels.
  
  
  CONCLUSIONS
  ADC measurements of the supra-adjacent discs after a mean follow-up of 32 months following thoracolumbar fractures, showed that restoration of the vertebral collapse by minimally invasive VAP prevents posttraumatic disc degeneration.
authors.affiliation: Spine Department, Valladolid University Hospital, Calle Ramon y Cajal 3, 47005, Valladolid, Spain.
authors.forename: David C
authors.initials: DC
authors.lastname: Noriega
authors.affiliation: Department of Radiology, SS. Trinità Hospital ASL 8 Cagliari, Via Is Mirrionis 92, 09121, Cagliari, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Marcia
authors.affiliation: Spine Department, Valladolid University Hospital, Calle Ramon y Cajal 3, 47005, Valladolid, Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: Ardura
authors.affiliation: Radiology Department, Valladolid University Hospital, Calle Ramon y Cajal 3, 47005, Valladolid, Spain.
authors.forename: Israel Sanchez
authors.initials: IS
authors.lastname: Lite
authors.affiliation: Department of Radiology, Azienda Ospedaliero Brotzu (A.O.B.), Cagliari, Italy.
authors.forename: Mariangela
authors.initials: M
authors.lastname: Marras
authors.affiliation: Department of Radiology, Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari - Polo di Monserrato s.s. 554, 09045, Monserrato, Cagliari, Italy. lucasaba@tiscali.it.
authors.forename: Luca
authors.initials: L
authors.lastname: Saba
mesh_terms: D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D005598:Fractures, Spontaneous / Q000601:surgery; D006801:Humans; D007403:Intervertebral Disc / Q000000981:diagnostic imaging; D055959:Intervertebral Disc Degeneration / Q000000981:diagnostic imaging*; D008159:Lumbar Vertebrae / Q000601:surgery; D008297:Male; D008875:Middle Aged; D016103:Spinal Fractures / Q000601:surgery*; D013904:Thoracic Vertebrae / Q000601:surgery
keywords: Clinical practice; MRI/MRA; Vertebroplasty/kyphoplasty