Work

Load-induced alterations in posterior parts of intervertebral discs in patients with load-induced pain during MRI; a detailed study using T2 maps

Year: 2025

Type: article

Abstract: PURPOSE: To use the effect of axial loading, captured with quantitative MRI, to investigate differences between load-induced behaviors of intervertebral discs (IVDs) in patients with non-specific low back pain (LBP) experiencing load-induced pain during MRI and those who do not. METHOD: In total, 178 LBP patients were imaged in the supine position with T2 mapping with and without loading. Intensity of daily pain and pain during imaging was graded from 0 to 10 Numerical Rating Scale (NRS). Patients were stratified according to whether or not they reported load-induced pain during imaging. Load-induced T2-value alterations in entire IVDs, and in central/posterior parts on levels L3/L4 to L5/S1 were compared between the groups using repeated measures analysis of variance and Fold-change. Results were adjusted for IVD-degeneration grade. RESULTS: Among the 120 patients reporting load-induced pain (mean NRS during examination: 5.8 vs. mean NRS for daily level: 5.7), 84% perceived it as concordant with their daily pain. In contrast, 58 patients reported no load-induced pain (mean NRS during examination 2.3 vs. mean NRS for daily pain level 5.4). Higher load-induced T2-value increases were observed in entire IVDs at L5/S1 (relative difference of 2% [95% CI; 0–5%]; p = .038) and in posterior regions at L3/L4 (relative difference of 4% [95% CI; 0–7%]; p = .033) among patients with load-induced pain compared to those without. DISCUSSION: Higher load-induced global and posterior T2-value increments in IVDs in LBP patients with load-induced pain suggest different biomechanical IVD-phenotypes between the two groups. Findings might be valuable in the ongoing work of identifying a non-invasive imaging-biomarker for pain in LBP patients.

Source: European Spine Journal

DOI: 10.1007/s00586-025-09262-5

Authors: Leif Torén, Helena Brisby, Christian Waldenberg, Kerstin Lagerstrand, Hanna Hebelka

Institution: Sahlgrenska University Hospital

Language: English

Topic: Spine and Intervertebral Disc Pathology

Subfield: Pathology and Forensic Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $2,790