Background/Purpose: To assess the glycosaminoglycan (GAG) content of lumbar intervertebral discs (IVD) in patients with low back pain (LBP) and radiculopathy using glycosaminoglycan chemical exchange saturation transfer imaging (gagCEST).

Methods: 258 lumbar IVDs of 53 participants, 21 healthy volunteers, 19 patients with LBP and 13 patients with radiculopathy (28 female; 25 male; mean age: 45.5 ± 16.7 years; range: 23 – 83 years), were examined with a 3T MRI scanner. Biochemical gagCEST imaging was used to determine the GAG content of each nucleus pulposus (NP) and annulus fibrosus (AF).

Results: Significantly reduced gagCEST values of NP were found in patients with LBP and/or radiculopathy (p < 0.0001) compared to healthy control group. NP gagCEST values were significantly lower in patients with LBP (p < 0.0001) and radiculopathy (p = 0.0005) compared to healthy volunteers, respectively. We saw an association between pain and GAG loss with significantly lower gagCEST values in participants with dorsal pain at examination day (p = 0.0004) and higher pain scores (p < 0.0001) compared to participants without LBP. Participants with body mass index ≥ 25 revealed lower gagCEST values compared to participants with BMI < 25 (p = 0.02).

Conclusion: GagCEST analysis indicated significantly lower GAG values of NP in patients with LBP or radiculopathy, in participants with elevated BMI, current pain at examination day and elevated pain scores.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/biochemical-intervertebral-disc-alterations-in-patients-with-low-back-pain-and-radiculopathy/