ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2026
Biochemical and microenvironmental characterization of the disc-vertebra complex in non-specific low back pain using non-fat-saturation multi-slice CEST MRI.
Article in 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, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeThis study aimed to characterize biochemical and microenvironmental changes within the Disc Vertebra Complex (DVC) in non-specific low back pain (NSLBP) patients using non-fat-saturation Multi-slices CEST MRI. By performing intra-group comparisons, we assessed associations between disc degeneration and vertebral biochemical variations.
methodsNinety-nine NSLBP patients (62 males, 37 females; median age 45) underwent lumbar spine MRI. Non-fat-saturation Multi-slices CEST imaging was used to assess fat fraction (FF), fat /water content and magnetization transfer contrast in vertebrates, and water content, glycosaminoglycan (GAG), amide proton transfer (APT), nuclear overhauser enhancement (NOE) and magnetization transfer contrast in discs. Metabolic and microenvironmental changes across vertebrae (L2-S1) and intervertebral discs (L2/3-L5/S1) were analyzed. Statistical comparisons were conducted across disc grades, weight categories, and disc abnormalities.
resultsSignificant biochemical variations were observed across vertebral levels, with decreasing water content and increasing FF from L2 to S1. The pH-sensitive markers (APT) showed caudal trends, indicating relative changes in proton environment. Protruding discs and discs with high-intensity zones (HIZ) showed reduced pH and hydration, alongside altered macromolecular structures. Adjacent vertebrae of protruding discs exhibited decreased water content, indicative of early bone marrow edema.
conclusionsNon-fat-saturation Multi-slices CEST MRI enables holistic profiling of the disc-vertebra complex (DVC) and detects localized, grade-dependent biochemical heterogeneity. Notably, differences emerged between vertebrae and discs with and without protrusion / HIZ, alongside grade-dependent variations.
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