The authors conducted a clinical evaluation of single-slab, 3-dimensional, T2-weighted turbo-spin-echo (TSE) with high sampling efficiency (SPACE) for high isotropic body imaging with large field-of-view (FoV). Fifty patients were examined in clinical routine with SPACE (regions of interest: pelvis n = 30, lower spine n = 12, upper spine n = 6, extremities n = 4) at 1.5 T. For achieving a high sampling efficiency, parallel imaging, high turbofactor, and magnetization restore pulses were used. In contrast to a conventional TSE imaging technique with constant flip angle refocusing, the refocusing pulse train of the SPACE sequence consists of variable flip angle radiofrequency pulses along the echo train. Signal-to-noise ratio and contrast-to-noise ratio of SPACE images were of sufficient diagnostic value. The possibility of image reconstruction in multiple planes was of clinical relevance in all cases and simplified data analysis. The achievement of 3-dimensional, T2-weighted TSE magnetic resonance imaging with isotropic and high spatial resolution and interactive 3-dimensional visualization essentially improve the diagnostic potential of magnetic resonance imaging.

Human intervertebral disc cells were harvested from patients with adolescent idiopathic scoliosis (AIS) and from donors with degenerative disc disease. Anulus fibrosis (AF) was separated from nucleus pulposus (NP), and cells were cultured separately in two different cell culture models. To investigate changes in gene expression of human disc cells during in vitro expansion and to determine whether cells from adolescent idiopathic scoliosis donors show different gene expression profiles compared with cells from patients operated for degenerative disc disease. During in vitro expansion, cells undergo a dedifferentiation process, which is characterized by a switch in gene expression. Markers for the differentiation and dedifferentiation status of human disc cells are not yet known. Moreover, it is not known whether changes in the gene expression pattern occur during the degeneration process. Cells from AF and NP tissues were expanded in monolayer and alginate cultures under controlled and defined conditions. Cells were then harvested, and analysis of phenotype was performed using quantitative real-time polymerase chain reaction (PCR). The mRNA expression of Type I, II, and X collagen, aggrecan, and interleukin-1beta in scoliosis and degenerative human intervertebral disc cells was analyzed. The gene expression of Type II and X collagen and of aggrecan significantly decreased for both cell types during monolayer expansion. Reexpression of all genes was observed when cells were cultured in alginate. Additionally, NP cells from degenerative tissues displayed significant lower levels of Type II collagen compared with NP cells from scoliosis donors. These results provide a better understanding of how the phenotype of human healthy and degenerative disc cells is influenced by in vitro expansion. This may be useful for future tissue engineering purposes.

If low back pain does not improve with conservative management, the cause of the pain must be determined before further therapy is initiated. Information obtained from the patient’s medical history, physical examination, and imaging may suffice to rule out many common causes of chronic pain (eg, fracture, malignancy, visceral or metabolic abnormality, deformity, inflammation, and infection). However, in most cases, the initial clinical and imaging findings have a low predictive value for the identification of specific pain-producing spinal structures. Diagnostic spinal injections performed in conjunction with imaging may be necessary to test the hypothesis that a particular structure is the source of pain. To ensure a valid test result, diagnostic injection procedures should be monitored with fluoroscopy, computed tomography, or magnetic resonance imaging. The use of controlled and comparative injections helps maximize the reliability of the test results. After a symptomatic structure has been identified,...

Study Design. Study to determine the internal consistency and validity of adapted German version of Scoliosis Research Society-22 (SRS-22) questionnaire. Objective. To evaluate the validity and reliability of adapted German version of SRS-22 questionnaire. Summary of Background Data. The SRS-22 questionnaire was developed to assess the health-related quality of life for English-speaking patients with idiopathic scoliosis. For scientific purpose and standardized comparison of outcome studies for the treatment of idiopathic scoliosis its adaptation into German is necessary to respect cultural and lingual differences. Methods. Translation/retranslation of the English version of the SRS-22 was conducted, and all steps for cross-cultural adaptation process were performed. Thus, SRS-22 questionnaire and previously validated Roland-Morris score were mailed to 222 patients who had been treated surgically or conservatively for idiopathic scoliosis. Seventy-eight patients (35%) responded to the first set of questionnaires and 54 of the first time responder returned their second survey. The median age of all patients who joined the study was 19 years. Measures of reliability namely, selectivity, internal consistency, and reproducibility were determined by Cronbach’s α statistics and intraclass correlation coefficient, respectively. Concurrent validity was measured by comparing with an already validated questionnaire (Roland-Morris score). Measurement was made using the Spearman correlation coefficient. Results. The study demonstrated satisfactory internal consistency with high Cronbach’s α values for 4 of the corresponding domains (pain, 0.75; self-image, 0.84; mental health, 0.88; and satisfaction, 0.61). However, the Cronbach’s α value for function/activity domain (0.67) was considerably lower than the original English questionnaire. For the same domains intraclass correlation coefficient demonstrating satisfactory test/retest reproducibility. Conclusion. The adapted German version of the SRS-22 questionnaire can be used to assess the outcome of treatment for German-speaking patients with idiopathic scoliosis.