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Lumbar annulus fibrosus biomechanical characterization in healthy children by ultrasound shear wave elastography

  • Musculoskeletal
  • Published:
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Abstract

Objectives

Intervertebral disc (IVD) is key to spine biomechanics, and it is often involved in the cascade leading to spinal deformities such as idiopathic scoliosis, especially during the growth spurt. Recent progress in elastography techniques allows access to non-invasive measurement of cervical IVD in adults; the aim of this study was to determine the feasibility and reliability of shear wave elastography in healthy children lumbar IVD.

Methods

Elastography measurements were performed in 31 healthy children (6–17 years old), in the annulus fibrosus and in the transverse plane of L5–S1 or L4–L5 IVD. Reliability was determined by three experienced operators repeating measurements.

Results

Average shear wave speed in IVD was 2.9 ± 0.5 m/s; no significant correlations were observed with sex, age or body morphology. Intra-operator repeatability was 5.0 % while inter-operator reproducibility was 6.2 %. Intraclass correlation coefficient was higher than 0.9 for each operator.

Conclusions

Feasibility and reliability of IVD shear wave elastography were demonstrated. The measurement protocol is compatible with clinical routine and the results show the method’s potential to give an insight into spine deformity progression and early detection.

Key Points

• Intervertebral disc mechanical properties are key to spine biomechanics

• Feasibility of shear wave elastography in children lumbar disc was assessed

• Measurement was fast and reliable

• Elastography could represent a novel biomarker for spine pathologies

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References

  1. Humzah MD, Soames RW (1988) Human intervertebral disc: structure and function. Anat Rec 220:337–356

    Article  CAS  PubMed  Google Scholar 

  2. Rohlmann A, Pohl D, Bender A et al (2014) Activities of everyday life with high spinal loads. PLoS One 9, e98510

    Article  PubMed  PubMed Central  Google Scholar 

  3. Modi H, Suh S, Song H-R, Yang J-H, Kim H-J, Modi C (2008) Differential wedging of vertebral body and intervertebral disc in thoracic and lumbar spine in adolescent idiopathic scoliosis - a cross sectional study in 150 patients. Scoliosis 3:11

    Article  PubMed  PubMed Central  Google Scholar 

  4. Hristova GI, Jarzem P, Ouellet JA et al (2011) Calcification in human intervertebral disc degeneration and scoliosis. J Orthop Res 29:1888–1895

    Article  PubMed  Google Scholar 

  5. Melrose J, Gurr KR, Cole TC, Darvodelsky A, Ghosh P, Taylor TK (1991) The influence of scoliosis and ageing on proteoglycan heterogeneity in the human intervertebral disc. J Orthop Res 9:68–77

    Article  CAS  PubMed  Google Scholar 

  6. Roberts S, Menage J, Eisenstein SM (1993) The cartilage end-plate and intervertebral disc in scoliosis: calcification and other sequelae. J Orthop Res 11:747–757

    Article  CAS  PubMed  Google Scholar 

  7. Stokes IA, Spence H, Aronsson DD, Kilmer N (1996) Mechanical modulation of vertebral body growth. Implications for scoliosis progression. Spine 21:1162–1167

    Article  CAS  PubMed  Google Scholar 

  8. Weiler C, Schietzsch M, Kirchner T, Nerlich AG, Boos N, Wuertz K (2012) Age-related changes in human cervical, thoracal and lumbar intervertebral disc exhibit a strong intra-individual correlation. Eur Spine J 21(Suppl 6):S810–S818

    Article  PubMed  Google Scholar 

  9. Walter BA, Korecki CL, Purmessur D, Roughley PJ, Michalek AJ, Iatridis JC (2011) Complex loading affects intervertebral disc mechanics and biology. Osteoarthr Cartil 19:1011–1018

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Little JP, Adam C (2012) Towards determining soft tissue properties for modelling spine surgery: current progress and challenges. Med Biol Eng Comput 50:199–209

    Article  PubMed  Google Scholar 

  11. Matsumoto T, Kitahara H, Minami S et al (1997) Flexibility in the scoliotic spine: three-dimensional analysis. J Spinal Disord 10:125–131

    Article  CAS  PubMed  Google Scholar 

  12. Farshad-Amacker NA, Nguyen TD, Farshad M, Andreisek G, Min K, Frauenfelder T (2015) Semiautomatic superimposition improves radiological assessment of curve flexibility in scoliosis. Eur Radiol 25:860–864

    Article  PubMed  Google Scholar 

  13. Cortes DH, Magland JF, Wright AC, Elliott DM (2014) The shear modulus of the nucleus pulposus measured using magnetic resonance elastography: a potential biomarker for intervertebral disc degeneration. Magn Reson Med 72:211–219

    Article  PubMed  PubMed Central  Google Scholar 

  14. Maquer G, Brandejsky V, Benneker LM, Watanabe A, Vermathen P, Zysset PK (2014) Human intervertebral disc stiffness correlates better with the Otsu threshold computed from axial T2 map of its posterior annulus fibrosus than with clinical classifications. Med Eng Phys 36:219–225

    Article  PubMed  Google Scholar 

  15. Streitberger K-J, Diederichs G, Guo J et al (2014) In vivo multifrequency magnetic resonance elastography of the human intervertebral disk. Magn Reson Med. doi:10.1002/mrm.25505

    PubMed  Google Scholar 

  16. Vergari C, Rouch P, Dubois G et al (2014) Non-invasive biomechanical characterization of intervertebral disc by shear wave elastography. Eur Radiol 24:3210–3216

    Article  PubMed  Google Scholar 

  17. Bercoff J, Tanter M, Fink M (2004) Supersonic shear imaging: a new technique for soft tissue elasticity mapping. IEEE Trans Ultrason Ferroelectr Freq Control 51:396–409

    Article  PubMed  Google Scholar 

  18. Royer D, Gennisson JL, Deffieux T, Tanter M (2011) On the elasticity of transverse isotropic soft tissues (L). J Acoust Soc Am 129:2757–2760

    Article  PubMed  Google Scholar 

  19. Vergari C, Rouch P, Dubois G et al (2014) Intervertebral disc characterization by shear wave elastography: an in-vitro preliminary study. Proc Inst Mech Eng H 228:607–615

    Article  PubMed  Google Scholar 

  20. Deswal A, Tamang BK, Bala A (2014) Study of aortic- common iliac bifurcation and its clinical significance. J Clin Diagn Res 8:AC06–AC08

    PubMed  PubMed Central  Google Scholar 

  21. Recuerda M, Cote SP, Villemure I, Preie D (2011) Influence of experimental protocols on the mechanical properties of the intervertebral disc in unconfined compression. J Biomech Eng 133:071006

    PubMed  Google Scholar 

  22. Costi JJ, Hearn TC, Fazzalari NL (2002) The effect of hydration on the stiffness of intervertebral discs in an ovine model. Clin Biomech (Bristol, Avon) 17:446–455

    Article  Google Scholar 

  23. Hirsch C, Galante J (1967) Laboratory conditions for tensile tests in annulus fibrosus from human intervertebral discs. Acta Orthop Scand 38:148–162

    Article  CAS  PubMed  Google Scholar 

  24. Kuo YW, Wang JL (2010) Rheology of intervertebral disc: an ex vivo study on the effect of loading history, loading magnitude, fatigue loading, and disc degeneration. Spine 35:E743–E752

    Article  PubMed  Google Scholar 

  25. Wing P, Tsang I, Gagnon F, Susak L, Gagnon R (1992) Diurnal changes in the profile shape and range of motion of the back. Spine 17:761–766

    Article  CAS  PubMed  Google Scholar 

  26. Tyrrell AR, Reilly T, Troup JD (1985) Circadian variation in stature and the effects of spinal loading. Spine 10:161–164

    Article  CAS  PubMed  Google Scholar 

  27. Lacourpaille L, Hug F, Bouillard K, Hogrel J-Y, Nordez A (2012) Supersonic shear imaging provides a reliable measurement of resting muscle shear elastic modulus. Physiol Meas 33:N19

    Article  PubMed  Google Scholar 

  28. DeWall RJ, Slane LC, Lee KS, Thelen DG (2014) Spatial variations in Achilles tendon shear wave speed. J Biomech 47:2685–2692

    Article  PubMed  PubMed Central  Google Scholar 

  29. Cosgrove D, Berg W, Doré C et al (2012) Shear wave elastography for breast masses is highly reproducible. Eur Radiol 22:1023–1032

    Article  PubMed  PubMed Central  Google Scholar 

  30. Wilson SR, Burns PN, Wilkinson LM, Simpson DH, Muradali D (1999) Gas at abdominal US: appearance, relevance, and analysis of artifacts. Radiology 210:113–123

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

The scientific guarantor of this publication is Prof. Wafa Skalli, (Institut de Biomecanique Humaine Georges Charpak, Arts et Metiers ParisTech, 151 bd de l'Hopital 75013 Paris, France). The authors of this manuscript declare relationships with the following companies: Jean-Luc Gennisson is a scientific consultant for SuperSonic Imagine, and Mickael Tanter is cofounder and shareholder of SuperSonic Imagine (Aix-en-Provence, France). The other authors do not have any conflicting financial interests. This study has received funding by the ParisTech BiomecAM chair program on subject-specific musculoskeletal modelling for funding (with the support of ParisTech and Yves Cotrel Foundations, Société Générale, Proteor and Covea) and by the “Investissements d'Avenir” program. We would also like to thank Dr. Pauline Lallemant and Ms. Sonia Simoes for their technical help. One of the authors has significant statistical expertise. Institutional review board approval was obtained.

Written informed consent was obtained from both parents of all minor subjects (patients) in this study.

Some study subjects or cohorts have been previously reported in national congresses. Methodology: prospective, cross-sectional study, multicentre study.

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Authors and Affiliations

  1. Arts et Metiers ParisTech, LBM/Institut de Biomecanique Humaine Georges Charpak, 151 bd de l’Hopital, 75013, Paris, France

    Claudio Vergari, Guillaume Dubois, Jean Dubousset, Philippe Rouch & Wafa Skalli

  2. Department of Paediatric Orthopaedics, Armand Trousseau Hospital, Université Pierre et Marie Curie-Paris 6, 75571, Paris, France

    Raphael Vialle

  3. Institut Langevin, Ondes et Images, ESPCI ParisTech, CNRS UMR7587, INSERM U979, Paris, France

    Jean-Luc Gennisson & Mickael Tanter

Authors
  1. Claudio Vergari
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  2. Guillaume Dubois
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  3. Raphael Vialle
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  4. Jean-Luc Gennisson
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  5. Mickael Tanter
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  6. Jean Dubousset
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  7. Philippe Rouch
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  8. Wafa Skalli
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Correspondence to Claudio Vergari.

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Vergari, C., Dubois, G., Vialle, R. et al. Lumbar annulus fibrosus biomechanical characterization in healthy children by ultrasound shear wave elastography. Eur Radiol 26, 1213–1217 (2016). https://doi.org/10.1007/s00330-015-3911-0

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  • DOI: https://doi.org/10.1007/s00330-015-3911-0

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