Author(s)

Sophie Heüveldop^1*, Florian Fichter^1*, Anja Müller-Lutz¹, Markus Konieczny², Markus Eichner¹, Hans-Jörg Wittsack¹, Christoph Schleich¹

¹Department of Diagnostic and Interventional Radiology, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany.
²Department of Orthopedics, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany.

Objective: To assess glycosaminoglycan (GAG) content of lumbar intervertebral discs (IVDs) in patients with radiculopathy compared with healthy volunteers with glycosaminoglycan chemical exchange saturation transfer (gagCEST). Methods: The lumbar spines of 15 patients with radiculopathy (9 women, 6 men; mean age 45 years; range: 19 - 80 years) and 13 healthy controls (10 women, 3 men; mean age 29 years; range: 19 - 38 years) without lumbar back pain or previous spine surgery were examined at a 3 Tesla (T) magnetic resonance imaging (MRI) scanner in this prospective study. The MRI protocol included standard morphological, sagittal, and transverse T2-weighted (T2w) images of the five lumbar IVDs (L1-S1) to assess Pfirrmann score and to detect disc disorders according to the Combined Task Force classification. To analyze biochemically the lumbar IVDs, a gagCEST sequence was applied to measure the GAG content of the nucleus pulposus (NP) and annulus fibrosus (AF). Results: Patients with radiculopathy indicated significantly lower gagCEST values in NP than healthy volunteers (2.82% ± 3.12% vs. 4.09% ± 2.25%, P = 0.017). The GAG content of AF showed no significant difference between volunteers and patients (2.66% ± 2.01% vs. 1.92% ± 2.56%; P = 0.175). Conclusions. Patients with radiculopathy presented with lower GAG values than healthy volunteers in NP, indicating an association between pain and IVD degeneration. gagCEST of lumbar IVDs is a powerful, non-invasive tool to investigate early disc degeneration, which we could demonstrate in the NP in our study collective.

Glycosaminoglycan Chemical Exchange Saturation Transfer, Radiculopathy, Intervertebral Disc, Lumbar Spine, Early Degeneration

Heüveldop, S. , Fichter, F. , Müller-Lutz, A. , Konieczny, M. , Eichner, M. , Wittsack, H. and Schleich, C. (2019) Assessment of Glycosaminoglycan Content of Lumbar Intervertebral Discs in Patients with Radiculopathy. International Journal of Clinical Medicine, 10, 259-269. doi: 10.4236/ijcm.2019.104020.