Ramos DLR, García MCM, Favila HR, Elías PB, Porras JMA, Baquera HJJ

Language: Spanish
References: 0
Page: 141-147
PDF size: 383.84 Kb.

ABSTRACT

Introduction: Anatomic and physiological alterations of intervertebral disks cause pain and disability to the human being, the disk degenerative process is being studied due to the little understanding about the process and its correlation with diagnosis tests.
Purpose: Understanding the aging process, the degeneration of intervertebral disks and their relation with pain. To establish the correlation between pathological findings with image studies and invite image professionals to use a clear language in interpreting the findings of radiological studies.
Method: A review of articles published all over the world on the subject matter.
Results: The concept of aging and the intervertebral disk degenerative process is still difficult to assess at the time of performing a clinic study to a patient with lumbar pain, to establish its existence and severity varies and is dependant, mostly, on the image methods used for diagnosis. The degenerative process is an inevitable consequence of aging, with structural changes and failure of its properties. Both processes, aging and degeneration, may have different development paths, widely vary in their symptoms and are both cause of pain.
The degenerative process of the disk is characterized by a complex morphologic, biochemical and biological changes spectrum that lead to a mechanical dysfunction and pain. The features identified in this process include: dehydration of the pulp chamber; loss of proteoglucans; gradual or premature decreased cellularity, with a metabolic process in which catabolism exceeds the restoration process; there is disorganization of the fibrous ring and annular sprains. Aside from other factors that participate in this triggering, such as genetic, environmental and nutritional, among others.
Magnetic Resonance is the method of choice for studying intervertebral disk degenerative changes, due to its capacity to expose the behavior of water in morbid processes. Typically, desiccation changes generate a loss of signal in the images emphasizing T2, linked to a progressive loss of disk height, aside from identifying other morphologic and focal changes in the intensity of the disk signal suggesting sprains and that are matched to structural, biochemical and biological changes found in the process that cause pain.
It is important for the image professional to consider that pain is not only caused by the radicular compression and that there are disk changes that are reflected in the MRI images that could explain the origin of pain. Likewise, the use of a nomenclature that enables a common and explicit language in exposing and understanding degenerative changes of the intervertebral disk when analyzing the studies of patients with pain.
Conclusion: Changes in the structure and function of intervertebral disk are part of an aging process that derives in a degenerative process, which may develop prematurely and cause lumbar pain. This can be correlated with MRI findings.