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This Article Figures Only Full Text Full Text (PDF) All Versions of this Article: ajnr.A1625v1 30/8/1541 most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Sharma, A. Articles by Pilgram, T.K. Search for Related Content PubMed PubMed Citation Articles by Sharma, A. Articles by Pilgram, T.K. Hotlight (NEW!) What's Hotlight? American Journal of Neuroradiology 30:1541-1545, September 2009 © 2009 American Society of Neuroradiology SPINE Temporal Association of Annular Tears and Nuclear Degeneration: Lessons from the Pediatric Population A. Sharma a ,b ,c , M.S. Parsons a ,b ,c and T.K. Pilgram a a From the Mallinckrodt Institute of Radiology (A.S., M.S.P., T.K.P.), Washington University School of Medicine, St. Louis, Mo b Department of Radiology (A.S., M.S.P.), Barnes-Jewish Hospital South, St. Louis, Mo c Department of Radiology (A.S., M.S.P.), St. Louis Children's Hospital, St. Louis, Mo. Please address correspondence to Aseem Sharma, MD, Mallinckrodt Institute of Radiology, Washington University School of Medicine, Campus Box 8131, 510 S Kingshighway Blvd, St. Louis, MO 63110; e-mail: sharmaa@mir.wustl.edu BACKGROUND AND PURPOSE: Studies done mainly in adults have shown an association between annular tears and nuclear degeneration. We wanted to study this association in the pediatric population to better understand the natural history of disk degeneration in its early stages. We hypothesized that this association is discernible even at a young age and that annular tears precede nuclear degeneration. MATERIALS AND METHODS: Twenty-six children with back pain and known disk pathology were identified from our radiology report data base. Two neuroradiologists independently evaluated T12 through S1 intervertebral disks in these images. One reader evaluated the disks for the presence and type of annular tears. The other reader graded the signal intensity of the disks on an ordinal scale and the extent of disk degeneration on the Pfirrmann scale. Mean degeneration and signal-intensity grades were compared for disks with radial tears, disks with nonradial tears, and disks without annular tears. RESULTS: Fifty-six disks had radial tears. These demonstrated significantly higher nuclear degeneration grades and greater signal-intensity loss than disks with nonradial tears or disks with no annular tears. About one third (30.3%) of the disks with radial tears had a normal nuclear signal intensity. Only 3% of disks with a signal-intensity grade of 3 had an intact annulus. CONCLUSIONS: Nuclear degeneration in children is associated with radial annular tears and rarely occurs in the absence of annular tears. Home Subscribe Author Instructions Submit Online Search the AJNR Archives Feedback Help Copyright © 2010 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X
American Journal of Neuroradiology – American Journal of Neuroradiology
Published: Sep 1, 2009
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