scispace - formally typeset
Search or ask a question
Journal ArticleDOI

Proposal for a New Scoring System for Spinal Degeneration: Mo-Fi-Disc

31 Jul 2020-Clinical Neurology and Neurosurgery (Elsevier)-Vol. 198, pp 106120-106120
TL;DR: A new scoring system for spinal degeneration including Modic changes, fatty infiltration in the paraspinal muscles, and intervertebral disc degeneration (IVDD), briefly Mo-fi-disc, suggests an easy and objective classification to evaluate the spinal degenerations.
About: This article is published in Clinical Neurology and Neurosurgery.The article was published on 2020-07-31. It has received 20 citations till now. The article focuses on the topics: Modic changes & Low back pain.
Citations
More filters
Journal ArticleDOI
TL;DR: In this paper, the role of obesity in the process of low back pain was investigated and increased body mass index (BMI) was associated with intervertebral disc degeneration (IVDD), vertebral end-plate changes and paraspinal muscle quality.

13 citations

Journal ArticleDOI
TL;DR: In this article , a cross-sectional analysis of a retrospective database in patients aged between 10 and 100 years was conducted to analyze change of intervertebral disc degeneration (IVDD) and Modic changes in Caucasians with LBP decade by decade.

11 citations

Journal ArticleDOI
TL;DR: Wang et al. as mentioned in this paper investigated whether the degree of lumbar disc degeneration was associated with fatty infiltration of paraspinal muscles and preliminarily explored the underlying mechanism, which may contribute to further understanding of LDD pathology.
Abstract: Abstract Background Low back pain (LBP) is associated with lumbar disc degeneration (LDD) and fatty infiltration of paraspinal muscles. However, there are some controversies about the relationship between LDD and fatty infiltration of paraspinal muscles, and the causation of them is also not clear. Thus, we investigated whether the degree of LDD was associated with fatty infiltration of paraspinal muscles and preliminarily explored the underlying mechanism. Methods A retrospective study was conducted on 109 patients with chronic LBP. The degree of LDD was assessed by the Pfirrmann classification. Total muscle cross-sectional area, L4 vertebral body endplate area, and fat cross-sectional area at axial T2-weighted MRI were measured. Multifidus and lumbar disc specimens were taken from eight individuals undergoing discectomy for disc herniation. Gene and protein expression levels of TNF were quantified through qPCR assays and ELISA, respectively. Results The relative cross-sectional area, total muscle cross-sectional area, and muscle cross-sectional area asymmetry were not related to LDD. Pfirrmann grades correlated strongly with fatty infiltration of the multifidus and moderately with fatty infiltration of the erector spinae and the psoas muscles. Linear regression analysis suggested that Pfirrmann grades were most associated with fatty infiltration of the multifidus. Compared with II-degree degeneration discs (mild-degeneration group), fatty infiltration of the multifidus in IV-degree degeneration discs (severe-degeneration group) significantly increased, accompanied by increased mRNA expression of TNF. Meanwhile, the protein expression levels of TNF (pg/g protein) in discs (16.62 ± 4.33) and multifidus (13.10 ± 2.76) of the severe-degeneration group were higher than those in the mild-degeneration group (disc: 9.75 ± 2.18; multifidus: 7.84 ± 2.43). However, the mRNA expression of TNF in the multifidus was not significantly different between the two groups. Conclusions The results suggest that LDD is associated with fatty infiltration of the multifidus. The possible underlying mechanism is that LDD induces fatty infiltration by inflammation. Furthermore, compared with the erector spinae and the psoas muscles, fatty infiltration of the multifidus shows an optimal correlation with LDD, which may contribute to further understanding of LDD pathology.

10 citations

Journal ArticleDOI
TL;DR: In this paper, the distribution pattern of modic changes in the vertebral end-plates was associated with the severity of intervertebral disc degeneration (IVDD) and Modic changes.

6 citations

Journal ArticleDOI
TL;DR: This poster presents a poster presented at the 2016 American Academy of Orthopaedic Surgeons General Conference on Spine and Scoliosis titled “Preparatory Caesarean Sections and Postoperative Pain Management: Foundations of Sports Medicine and Rehabilitation.”
Abstract: *Department of Physical Medicine and Rehabilitation, University of Utah, Salt Lake City, UT, USA; Department of Orthopaedics, Stanford University, Redwood City, CA, USA; The University of Texas Dell Medical School, Ascension Texas Spine and Scoliosis, Austin, TX, USA; Department of Orthopaedics, University of California San Francisco, San Francisco, CA, USA; Virginia iSpine Physicians, PC, Richmond, VA, USA

5 citations

References
More filters
Journal ArticleDOI
01 Sep 2001-Spine
TL;DR: Disc degeneration can be graded reliably on routine T2-weighted magnetic resonance images using the grading system and algorithm presented in this investigation.
Abstract: Study design A reliability study was conducted Objectives To develop a classification system for lumbar disc degeneration based on routine magnetic resonance imaging, to investigate the applicability of a simple algorithm, and to assess the reliability of this classification system Summary of background data A standardized nomenclature in the assessment of disc abnormalities is a prerequisite for a comparison of data from different investigations The reliability of the assessment has a crucial influence on the validity of the data Grading systems of disc degeneration based on state of the art magnetic resonance imaging and corresponding reproducibility studies currently are sparse Methods A grading system for lumbar disc degeneration was developed on the basis of the literature An algorithm to assess the grading was developed and optimized by reviewing lumbar magnetic resonance examinations The reliability of the algorithm in depicting intervertebral disc alterations was tested on the magnetic resonance images of 300 lumbar intervertebral discs in 60 patients (33 men and 27 women) with a mean age of 40 years (range, 10-83 years) All scans were analyzed independently by three observers Intra- and interobserver reliabilities were assessed by calculating kappa statistics Results There were 14 Grade I, 82 Grade II, 72 Grade III, 68 Grade IV, and 64 Grade V discs The kappa coefficients for intra- and interobserver agreement were substantial to excellent: intraobserver (kappa range, 084-090) and interobserver (kappa range, 069-081) Complete agreement was obtained, on the average, in 838% of all the discs A difference of one grade occurred in 159% and a difference of two or more grades in 13% of all the cases Conclusion Disc degeneration can be graded reliably on routine T2-weighted magnetic resonance images using the grading system and algorithm presented in this investigation

3,048 citations

Journal ArticleDOI
TL;DR: A preoperative computed tomography scan grading muscular fatty degeneration in five stages was done in 63 patients scheduled for repair of a torn rotator cuff, finding that infraspinatus degeneration had a highly negative influence on the outcome of suprasp inatus repairs.
Abstract: A preoperative computed tomography (CT) scan grading muscular fatty degeneration in five stages was done in 63 patients scheduled for repair of a torn rotator cuff. The results were compared with postoperative evaluation done after a mean of 17.7 months in 57 patients. Postoperative arthrographies were also performed in 56 patients. Preoperative CT scans demonstrated that infraspinatus fatty degeneration can occur in the presence of large anterosuperior tears even when the infraspinatus tendon is not torn; it worsens with time. The subscapularis rarely degenerates, and when it does it degenerates moderately, even when its tendon is not torn. After an effective surgical repair, moderate supraspinatus degeneration regressed in six of 14 patients; that of the infraspinatus never regressed but rather, increased, in three patients. One of these deteriorations, involving both supra- and infraspinatus, could probably be attributed to a partial subscapular nerve injury. Infraspinatus degeneration was correlated with functional pre- and postoperative impairment of active external rotation. Recurrence of infraspinatus tear was never observed, but recurrence occurred in 25% of supraspinatus repairs. Infraspinatus degeneration had a highly negative influence on the outcome of supraspinatus repairs. It seems preferable to operate on wide tears before irreversible muscular damage takes place.

2,484 citations

Journal ArticleDOI
TL;DR: All three pain-rating scales are valid, reliable and appropriate for use in clinical practice, although the Visual Analogue Scale has more practical difficulties than the Verbal Rating Scale or the Numerical Rating Scale.
Abstract: Aims and objectives. This review aims to explore the research available relating to three commonly used pain rating scales, the Visual Analogue Scale, the Verbal Rating Scale and the Numerical Rating Scale. The review provides information needed to understand the main properties of the scales. Background. Data generated from pain-rating scales can be easily misunderstood. This review can help clinicians to understand the main features of these tools and thus use them effectively. Method. A MedLine review via PubMed was carried out with no restriction of age of papers retrieved. Papers were examined for methodological soundness before being included. The search terms initially included pain rating scales, pain measurement, Visual Analogue Scale, VAS, Verbal Rating Scale, VRS, Numerical/numeric Rating Scale, NRS. The reference lists of retrieved articles were used to generate more papers and search terms. Only English Language papers were examined. Conclusions. All three pain-rating scales are valid, reliable and appropriate for use in clinical practice, although the Visual Analogue Scale has more practical difficulties than the Verbal Rating Scale or the Numerical Rating Scale. For general purposes the Numerical Rating Scale has good sensitivity and generates data that can be statistically analysed for audit purposes. Patients who seek a sensitive pain-rating scale would probably choose this one. For simplicity patients prefer the Verbal Rating Scale, but it lacks sensitivity and the data it produces can be misunderstood. Relevance to clinical practice. In order to use pain-rating scales well clinicians need to appreciate the potential for error within the tools, and the potential they have to provide the required information. Interpretation of the data from a pain-rating scale is not as straightforward as it might first appear.

2,337 citations

Journal ArticleDOI
TL;DR: Signal intensity changes appear to reflect a spectrum of vertebral body marrow changes associated with degenerative disk disease in patients referred for lumbar spine MR imaging.
Abstract: The authors reviewed magnetic resonance (MR) images of 474 consecutive patients referred for lumbar spine MR imaging. Type 1 changes (decreased signal intensity on T1-weighted spin-echo images and increased signal intensity on T2-weighted images) were identified in 20 patients (4%) and type 2 (increased signal intensity on T1-weighted images and isointense or slightly increased signal intensity on T2-weighted images) in 77 patients (16%). In all cases there was evidence of associated degenerative disk disease at the level of involvement. Histopathologic sections in three cases of type 1 change demonstrated disruption and fissuring of the end plates and vascularized fibrous tissue, while in three cases of type 2 change they demonstrated yellow marrow replacement. In addition, 16 patients with end-plate changes documented with MR were studied longitudinally. Type 1 changes in five of six patients converted to a type 2 pattern in 14 months to 3 years. Type 2 changes in ten patients remained stable over a 2-3...

1,611 citations

Related Papers (5)