MRI-biochemical follow up measurements of lumbar intervertebral disc in patients with leg length discrepancy: Is it possible to alter cartilage damage with conservative therapy?

Frenken, Miriam; Latz, David; Schiffner, Erik; Quante, Wolfgang Alois; Knautz, Maxime; Abrar, Daniel Benjamin; Schaarschmidt, Benedikt; Schleich, Christoph · J Orthop · 2019

prospective_cohort · Level II

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Abstract

Effect of conservative therapy on intervertebral discs (IVD) in patients with leg-length-discrepancy (LLD). Seventy lumbar IVDs of 14 participants (five with LLD 10-20 mm) were examined using a 3T-MRI-scanner. Morphological (Pfirrmann) and molecular (glycosaminoglycan-chemical-exchange-saturation-transfer, gagCEST) grading was assessed before and after a four-month therapy (physiotherapy and shoe inlays). Significantly lower GAG values in patients with LLD were found (L5/S1, p = 0.02). After therapy, a trend towards higher gagCEST values in patients with LLD was observed (2.48 ± 1.77% vs. 1.79 ± 0.79%; p > 0.05). LLD represents a risk factor for molecular alterations of lumbar IVDs. Only minor effects of conservative therapy on these alterations could be found.

Anatomy