Evidence map›Paper›PMID 32449035›Full record

ArticleSpine deformity2020

Quantifying the effect of posterior spinal instrumentation on the MRI signal of adjacent intervertebral discs.

Mary H Foltz, Robert M O'Leary, Diana Reader, Nicholas L Rudolph, Krista A Schlitter, Jutta Ellermann, Casey P Johnson, David W Polly, Arin M Ellingson

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Spine deformity, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.1field-weighted citation impact, top 53% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 citations in OpenAlex.

  1. A preliminary assessment of intervertebral disc health and pathoanatomy changes observed two years following anterior vertebral body tethering.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2021
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 2 institutions in 1 country.

Mary H FoltzDivision of Rehabilitation Science, Department of Rehabilitation Medicine, Medical School, University of Minnesota, Minneapolis, MN, USA.
Robert M O'LearyDivision of Physical Therapy, Department of Rehabilitation Medicine, Medical School, University of Minnesota, Minneapolis, MN, USA.
Diana ReaderDivision of Physical Therapy, Department of Rehabilitation Medicine, Medical School, University of Minnesota, Minneapolis, MN, USA.
Nicholas L RudolphDivision of Physical Therapy, Department of Rehabilitation Medicine, Medical School, University of Minnesota, Minneapolis, MN, USA.
Krista A SchlitterDivision of Physical Therapy, Department of Rehabilitation Medicine, Medical School, University of Minnesota, Minneapolis, MN, USA.
Jutta EllermannDepartment of Radiology, Medical School, University of Minnesota, Minneapolis, MN, USA.
Casey P JohnsonCenter for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, USA.
David W PollyDepartment of Orthopaedic Surgery, Medical School, University of Minnesota, Minneapolis, MN, USA.
Arin M EllingsonDivision of Rehabilitation Science, Department of Rehabilitation Medicine, Medical School, University of Minnesota, Minneapolis, MN, USA. ellin224@umn.edu.ORCID http://orcid.org/0000-0001-6154-8035
University of Minnesota Medical Center · USUniversity of Minnesota · US

Funding

TRD4 - Ultrahigh Field Engineering and SafetyP41EB027061 · NIBIB · UNIVERSITY OF MINNESOTA · PI Gregory John Metzger · 2019 to 2026
$11.7M
NMR Imaging and SpectroscopyP41EB015894 · NIBIB · UNIVERSITY OF MINNESOTA · PI UGURBIL, KAMIL · 2012 to 2017
$8.4M
Interdisciplinary Engineering Career Development Center in Movement and Rehabilitation SciencesK12HD073945 · NICHD · NORTHWESTERN UNIVERSITY AT CHICAGO · PI DEWALD, JULIUS P, REINKENSMEYER, DAVID JAY · 2012 to 2021
$7.9M
Ultrahigh-Field MRI of Hip Joint Diseases Leading to Early OsteoarthritisK01AR070894 · NIAMS · UNIVERSITY OF MINNESOTA · PI JOHNSON, CASEY PETER · 2017 to 2021
$649k
High Performance Connectome Upgrade for Human 3T MR ScannerS10OD017974 · OD · UNIVERSITY OF MINNESOTA · PI LIM, KELVIN O. · 2014 to 2014
$600k
NIAMS NIH HHS K01 AR070894NIBIB NIH HHS P41 EB015894NIBIB NIH HHS P41 EB027061NICHD NIH HHS K12 HD073945NIH HHS S10 OD017974
6 · The paper itself

Abstract

STUDY

designEx vivo porcine imaging study.

objectivesQuantitatively evaluate change in MRI signal at the discs caudal to spinal fusion instrumentation. Individuals who receive posterior spinal instrumentation are at risk of developing accelerated disc degeneration at adjacent levels. Degeneration is associated with a loss of biochemical composition and mechanical integrity of the disc, which can be noninvasively assessed through quantitative T2* (qT2*) MRI techniques. However, qT2* is sensitive to magnetic susceptibility introduced by metal.

methodsNine ex vivo porcine lumbar specimens were imaged with 3 T MRI. Fast spin-echo T2-weighted (T2w) images and gradient-echo qT2* maps were acquired, both without and with posterior spinal fusion instrumentation. Average T2* relaxation times of the nuclei pulposi (NP) were measured at the adjacent and sub-adjacent discs and measurements were compared using t tests before and after instrumentation. The size of the signal void and metal artifact were determined (modified ASTM F2119-07) within the vertebral body and spinal cord for both MRI sequences. The relationship between T2* signal loss and distance from the instrumentation was evaluated using Pearson's correlation.

resultsThere was no significant difference between adjacent and sub-adjacent NP T2* relaxation time prior to instrumentation (p = 0.86). Following instrumentation, there was a significant decrease in the T2* relaxation time at the adjacent NP (average = 20%, p = 0.02), and no significant difference at the sub-adjacent NP (average = - 3%, p = 0.30). Furthermore, there was a significant negative correlation between signal loss and distance to disc (r = - 0.61, p < 0.01).

conclusionsSpinal fusion instrumentation interferes with T2* relaxation time measurements at the adjacent disc but not at the sub-adjacent discs. However, there is sufficient signal at the adjacent disc to quantify changes in the T2* relaxation time following spinal fusion. Hence, baseline MRI scan following spinal fusion surgery are required to interpret and track changes in disc health at the caudal discs. LEVEL OF EVIDENCE: N/A.

Indexed as

Diffusion Magnetic Resonance ImagingAnimalsArtifactsIntervertebral Disc DegenerationPostoperative ComplicationsSpinal FusionSwineAdjacent disc diseaseDisc healthImage artifactMetal artifactMetal interferenceSpinal fusion instrumentation

Identifiers

PMID32449035
PMCPMC7541587
OpenAlexW3027501559

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.