In vitro measurement of pressure in intervertebral discs and annulus fibrosus with and without annular tears during discography

Sang Heon Lee, Richard Derby, Yeng Chen, Kwan Sik Seo, Mi Jung Kim

Research output: Contribution to journalArticle

39 Citations (Scopus)

Abstract

Background context: Discogram studies have shown that pain reproduction correlates with the extent of annular disruption. However, it has not been assessed if pressure changes in the annulus fibrosus vary incrementally with intradiscal pressure. Purpose: To determine the relationship between intradiscal pressure and outer annular pressure during discography in intervertebral discs with and without annular tears. Study design: Intradiscal and periannular pressures were measured simultaneously in vitro during intradiscal injection in porcine cadaver spines. Methods: Twenty fresh porcine cadaver lumbar spines with intervening discs were tested. Intradiscal and periannular pressures were measured simultaneously using two pressure sensors during intradiscal contrast injection. The tip of a 25-gauge needle connected with a pressure manometer was placed in the center of the nucleus pulposus. A second pressure transducer was located at the outer third of the annulus fibrosus. Needle and transducer locations were confirmed by fluoroscopy. To compare the intact and torn annulus fibrosus, annular disruptions were created with a 20-gauge needle and confirmed by fluoroscopy. Results: During intradiscal injections of discs with an intact annulus, annulus fibrosus pressure remained low and a sharp increase in intradiscal pressure was observed. Significantly higher pressures were noted in the outer annulus in discs with annular tears (p<.01). Mean pressures at the central nucleus pulposus, the outer third of intact annuli and torn annuli were 93.4±40.9 psi, 14.8±1.9 psi and 85.7±24.8 psi, respectively. Conclusions Volumetric injection of intervertebral discs with a torn annulus fibrosis during discography may increase intra-annular pressure similar to the increase in pressure that may occur during spinal loading activities. This effect may not occur in discs with an intact annulus fibrosus.

Original languageEnglish
Pages (from-to)614-618
Number of pages5
JournalSpine Journal
Volume4
Issue number6
DOIs
Publication statusPublished - 2004 Nov 1
Externally publishedYes

Fingerprint

Intervertebral Disc
Tears
Pressure
Needles
Injections
Fluoroscopy
In Vitro Techniques
Annulus Fibrosus
Cadaver
Spine
Swine
Pressure Transducers
Transducers
Reproduction
Fibrosis

Keywords

  • Annular tear
  • Discography
  • Intradiscal pressure
  • Periannular pressure

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

In vitro measurement of pressure in intervertebral discs and annulus fibrosus with and without annular tears during discography. / Lee, Sang Heon; Derby, Richard; Chen, Yeng; Seo, Kwan Sik; Kim, Mi Jung.

In: Spine Journal, Vol. 4, No. 6, 01.11.2004, p. 614-618.

Research output: Contribution to journalArticle

Lee, Sang Heon ; Derby, Richard ; Chen, Yeng ; Seo, Kwan Sik ; Kim, Mi Jung. / In vitro measurement of pressure in intervertebral discs and annulus fibrosus with and without annular tears during discography. In: Spine Journal. 2004 ; Vol. 4, No. 6. pp. 614-618.
@article{206f1b60c69c4d30bab732fff7ef2f8f,
title = "In vitro measurement of pressure in intervertebral discs and annulus fibrosus with and without annular tears during discography",
abstract = "Background context: Discogram studies have shown that pain reproduction correlates with the extent of annular disruption. However, it has not been assessed if pressure changes in the annulus fibrosus vary incrementally with intradiscal pressure. Purpose: To determine the relationship between intradiscal pressure and outer annular pressure during discography in intervertebral discs with and without annular tears. Study design: Intradiscal and periannular pressures were measured simultaneously in vitro during intradiscal injection in porcine cadaver spines. Methods: Twenty fresh porcine cadaver lumbar spines with intervening discs were tested. Intradiscal and periannular pressures were measured simultaneously using two pressure sensors during intradiscal contrast injection. The tip of a 25-gauge needle connected with a pressure manometer was placed in the center of the nucleus pulposus. A second pressure transducer was located at the outer third of the annulus fibrosus. Needle and transducer locations were confirmed by fluoroscopy. To compare the intact and torn annulus fibrosus, annular disruptions were created with a 20-gauge needle and confirmed by fluoroscopy. Results: During intradiscal injections of discs with an intact annulus, annulus fibrosus pressure remained low and a sharp increase in intradiscal pressure was observed. Significantly higher pressures were noted in the outer annulus in discs with annular tears (p<.01). Mean pressures at the central nucleus pulposus, the outer third of intact annuli and torn annuli were 93.4±40.9 psi, 14.8±1.9 psi and 85.7±24.8 psi, respectively. Conclusions Volumetric injection of intervertebral discs with a torn annulus fibrosis during discography may increase intra-annular pressure similar to the increase in pressure that may occur during spinal loading activities. This effect may not occur in discs with an intact annulus fibrosus.",
keywords = "Annular tear, Discography, Intradiscal pressure, Periannular pressure",
author = "Lee, {Sang Heon} and Richard Derby and Yeng Chen and Seo, {Kwan Sik} and Kim, {Mi Jung}",
year = "2004",
month = "11",
day = "1",
doi = "10.1016/j.spinee.2004.03.021",
language = "English",
volume = "4",
pages = "614--618",
journal = "Spine Journal",
issn = "1529-9430",
publisher = "Elsevier Inc.",
number = "6",

}

TY - JOUR

T1 - In vitro measurement of pressure in intervertebral discs and annulus fibrosus with and without annular tears during discography

AU - Lee, Sang Heon

AU - Derby, Richard

AU - Chen, Yeng

AU - Seo, Kwan Sik

AU - Kim, Mi Jung

PY - 2004/11/1

Y1 - 2004/11/1

N2 - Background context: Discogram studies have shown that pain reproduction correlates with the extent of annular disruption. However, it has not been assessed if pressure changes in the annulus fibrosus vary incrementally with intradiscal pressure. Purpose: To determine the relationship between intradiscal pressure and outer annular pressure during discography in intervertebral discs with and without annular tears. Study design: Intradiscal and periannular pressures were measured simultaneously in vitro during intradiscal injection in porcine cadaver spines. Methods: Twenty fresh porcine cadaver lumbar spines with intervening discs were tested. Intradiscal and periannular pressures were measured simultaneously using two pressure sensors during intradiscal contrast injection. The tip of a 25-gauge needle connected with a pressure manometer was placed in the center of the nucleus pulposus. A second pressure transducer was located at the outer third of the annulus fibrosus. Needle and transducer locations were confirmed by fluoroscopy. To compare the intact and torn annulus fibrosus, annular disruptions were created with a 20-gauge needle and confirmed by fluoroscopy. Results: During intradiscal injections of discs with an intact annulus, annulus fibrosus pressure remained low and a sharp increase in intradiscal pressure was observed. Significantly higher pressures were noted in the outer annulus in discs with annular tears (p<.01). Mean pressures at the central nucleus pulposus, the outer third of intact annuli and torn annuli were 93.4±40.9 psi, 14.8±1.9 psi and 85.7±24.8 psi, respectively. Conclusions Volumetric injection of intervertebral discs with a torn annulus fibrosis during discography may increase intra-annular pressure similar to the increase in pressure that may occur during spinal loading activities. This effect may not occur in discs with an intact annulus fibrosus.

AB - Background context: Discogram studies have shown that pain reproduction correlates with the extent of annular disruption. However, it has not been assessed if pressure changes in the annulus fibrosus vary incrementally with intradiscal pressure. Purpose: To determine the relationship between intradiscal pressure and outer annular pressure during discography in intervertebral discs with and without annular tears. Study design: Intradiscal and periannular pressures were measured simultaneously in vitro during intradiscal injection in porcine cadaver spines. Methods: Twenty fresh porcine cadaver lumbar spines with intervening discs were tested. Intradiscal and periannular pressures were measured simultaneously using two pressure sensors during intradiscal contrast injection. The tip of a 25-gauge needle connected with a pressure manometer was placed in the center of the nucleus pulposus. A second pressure transducer was located at the outer third of the annulus fibrosus. Needle and transducer locations were confirmed by fluoroscopy. To compare the intact and torn annulus fibrosus, annular disruptions were created with a 20-gauge needle and confirmed by fluoroscopy. Results: During intradiscal injections of discs with an intact annulus, annulus fibrosus pressure remained low and a sharp increase in intradiscal pressure was observed. Significantly higher pressures were noted in the outer annulus in discs with annular tears (p<.01). Mean pressures at the central nucleus pulposus, the outer third of intact annuli and torn annuli were 93.4±40.9 psi, 14.8±1.9 psi and 85.7±24.8 psi, respectively. Conclusions Volumetric injection of intervertebral discs with a torn annulus fibrosis during discography may increase intra-annular pressure similar to the increase in pressure that may occur during spinal loading activities. This effect may not occur in discs with an intact annulus fibrosus.

KW - Annular tear

KW - Discography

KW - Intradiscal pressure

KW - Periannular pressure

UR - http://www.scopus.com/inward/record.url?scp=8644273305&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=8644273305&partnerID=8YFLogxK

U2 - 10.1016/j.spinee.2004.03.021

DO - 10.1016/j.spinee.2004.03.021

M3 - Article

C2 - 15541691

AN - SCOPUS:8644273305

VL - 4

SP - 614

EP - 618

JO - Spine Journal

JF - Spine Journal

SN - 1529-9430

IS - 6

ER -