MRI-biochemical follow up measurements of lumbar intervertebral disc in patients with leg length discrepancy: Is it possible to alter cartilage damage with conservative therapy?

OBJECTIVE: Effect of conservative therapy on intervertebral discs (IVD) in patients with leg-length-discrepancy (LLD). M&M: Seventy lumbar IVDs of 14 participants (five with LLD 10-20 mm) were examined using a 3T-MRI-scanner. Morphological (Pfirrmann) and molecular (glycosaminoglycan-chemical-exchange-saturation-transfer, gagCEST) grading was assessed before and after a four-month therapy (physiotherapy and shoe inlays). RESULTS: Significantly lower GAG values in patients with LLD were found (L5/S1, p = 0.02). After therapy, a trend towards higher gagCEST values in patients with LLD was observed (2.48 ±â€¯1.77% vs. 1.79 ±â€¯0.79%; p > 0.05). CONCLUSION: LLD represents a risk factor for molecular alterations of lumbar IVDs. Only minor effects of conservative therapy on these alterations could be found.

Assessment of glycosaminoglycan content in intervertebral discs of patients with leg length discrepancy: A pilot study.

OBJECTIVE: Leg length discrepancy (LLD) could be a predisposing factor for early degeneration of lumbar intervertebral discs (IVD). The purpose of this study was to elucidate the molecular effect of LLD on IVDs. METHODS: IVDs of Eleven patients (25.6 ±â€¯4.3years) with LLD (>10 mm) and 14 control subjects (23.9 ±â€¯3.5years) were compared using a 3T-MR scanner. Morphological T2-weighted and glycosaminoglycan-chemical-exchange-saturation-transfer (gagCEST) sequences were performed. RESULTS: No differences in morphological Pfirrmann grading were found (p > 0.05). In contrast, nucleus-pulposus-gagCEST-values of L5/S1 were significantly lower (p = 0.0008). CONCLUSION: Our results suggest that LLD is a predisposing factor for molecular IVD alterations, which are detectable even before morphological pathologies could be found.