Objective quantification of intervertebral disc volume properties using MRI in idiopathic scoliosis surgery

The aim of this study was to quantify from magnetic resonance imaging (MRI) the volume and hydration variation of the intervertebral disc in the lumbar spine before and after surgery in severe idiopathic scoliosis cases. MRI data were posttreated using a custom-made image processing software to semiautomatically derive volume properties of disc, annulus fibrosus and nucleus pulposus. The nucleus-disc volume ratio was also an indicator of the hydration level. The MRI that was performed in the clinical protocol concerned 28 patients with severe idiopathic scoliosis; four types of surgical instrumentations were used. The reliability of the three-dimensional reconstruction process was initially verified using an intraoperator reproducibility test. Original preoperative data on disc volume properties were then derived. Postoperative volume variations were quantified in discs below spine fusion, taking into account the level of arthrodesis and the disc location. It showed that the postoperative volume criteria increased significantly for nucleus, disc and nucleus-disc volume ratio and that some magnitude modulation could be conditioned by the location of surgical instrumentation. It tended to prove that the recovery of balanced physiological positioning and inherent biomechanical loads could induce a restored hydration of disc, which should favor the remodeling of free segments. This work was the first report to deal with the consequences of scoliosis surgery on subjacent disc in terms of volume and hydration properties. The clinical outcome will follow based on the patient cohort follow-up at 1 year after surgery.