Abstract：
MRS was shown to reliably quantify relative levels of degenerative pain biomarkers, differentiating painful versus non-painful discs in patients with chronic discogenic low back pain (DLBP), and this correlates with surgical success rates. We now report results based on more patients and longer follow-up.
Disc MRS was performed in DLBP patients who subsequently received lumbar surgery. Custom post-processing (NOCISCAN-LS®; Aclarion Inc.) calculated disc-specific NOCISCORES® that reflect relative differences in degenerative pain biomarkers for diagnosing chemically painful discs. Outcomes in 78 patients were evaluated using Oswestry Disability Index (ODI) scores. Surgical success (≥ 15-point ODI improvement) was compared between surgeries that were \"Concordant\" (Group C) versus \"Discordant\" (Group D) with NOCISCORE-based diagnosis for painful discs.
Success rates were higher for Group C versus Group D: 6 months (88% vs. 62%; p = 0.01), 12 months (91% vs. 56%; p < 0.001), and 24 months (85% vs. 63%; p = 0.07). Success rates for Group C surgeries were also higher than Group D surgeries in a variety of sub-group comparisons. Group C had a greater reduction in ODI from pre-operative to follow-up than Group D [absolute change (% change), (p)]: 6 months: - 35 (- 61%) versus - 23 (- 39%), (p < 0.05); 12 months: - 39 (- 69%) versus - 22 (- 39%), (p < 0.01); and 24 months: - 38 (- 66%) versus - 26 (- 48%), (p < 0.05).
More successful, sustained outcomes were obtained when surgically treating chemically painful discs identified by NOCISCAN-LS post-processed disc MRS exams. Results suggest that NOCISCAN-LS provides a valuable new diagnostic tool to help clinicians better select treatment levels.
Disc MRS was performed in DLBP patients who subsequently received lumbar surgery. Custom post-processing (NOCISCAN-LS®; Aclarion Inc.) calculated disc-specific NOCISCORES® that reflect relative differences in degenerative pain biomarkers for diagnosing chemically painful discs. Outcomes in 78 patients were evaluated using Oswestry Disability Index (ODI) scores. Surgical success (≥ 15-point ODI improvement) was compared between surgeries that were \"Concordant\" (Group C) versus \"Discordant\" (Group D) with NOCISCORE-based diagnosis for painful discs.
Success rates were higher for Group C versus Group D: 6 months (88% vs. 62%; p = 0.01), 12 months (91% vs. 56%; p < 0.001), and 24 months (85% vs. 63%; p = 0.07). Success rates for Group C surgeries were also higher than Group D surgeries in a variety of sub-group comparisons. Group C had a greater reduction in ODI from pre-operative to follow-up than Group D [absolute change (% change), (p)]: 6 months: - 35 (- 61%) versus - 23 (- 39%), (p < 0.05); 12 months: - 39 (- 69%) versus - 22 (- 39%), (p < 0.01); and 24 months: - 38 (- 66%) versus - 26 (- 48%), (p < 0.05).
More successful, sustained outcomes were obtained when surgically treating chemically painful discs identified by NOCISCAN-LS post-processed disc MRS exams. Results suggest that NOCISCAN-LS provides a valuable new diagnostic tool to help clinicians better select treatment levels.
摘要：
目的：MRS被证明可以可靠地量化退行性疼痛生物标志物的相对水平，区分慢性椎间盘源性下腰痛（DLBP）患者的疼痛性和非疼痛性椎间盘，这与手术成功率相关。我们现在报告基于更多患者和更长随访的结果。
方法：对随后接受腰椎手术的DLBP患者进行椎间盘MRS检查。自定义后处理（NOCISCAN-LS®;AclarionInc.）计算的椎间盘特异性NOCISCORES®，反映了用于诊断化学疼痛椎间盘的退行性疼痛生物标志物的相对差异。使用Oswestry残疾指数（ODI）评分评估了78例患者的预后。比较了“一致”（C组）与“不一致”（D组）的手术之间的手术成功率（ODI改善≥15点），并基于NOCISCORE诊断为疼痛性椎间盘。
结果：C组成功率高于D组：6个月（88%vs.62%；p=0.01），12个月（91%与56%；p<0.001)，和24个月(85%vs.63%；p=0.07）。在各种亚组比较中，C组手术的成功率也高于D组手术。C组在术前至随访期间的ODI下降幅度大于D组[绝对变化(%变化),（p）]：6个月：-35（-61%）对-23（-39%），（p<0.05）；12个月：-39（-69%）对-22（-39%），(p<0.01)；24个月：-38(-66%)对-26(-48%)，(p<0.05)。
结论：更成功，通过NOCISCAN-LS后处理椎间盘MRS检查确定的化学疼痛性椎间盘手术治疗可获得持续结局.结果表明，NOCISCAN-LS提供了一种有价值的新诊断工具，可以帮助临床医生更好地选择治疗水平。
方法：对随后接受腰椎手术的DLBP患者进行椎间盘MRS检查。自定义后处理（NOCISCAN-LS®;AclarionInc.）计算的椎间盘特异性NOCISCORES®，反映了用于诊断化学疼痛椎间盘的退行性疼痛生物标志物的相对差异。使用Oswestry残疾指数（ODI）评分评估了78例患者的预后。比较了“一致”（C组）与“不一致”（D组）的手术之间的手术成功率（ODI改善≥15点），并基于NOCISCORE诊断为疼痛性椎间盘。
结果：C组成功率高于D组：6个月（88%vs.62%；p=0.01），12个月（91%与56%；p<0.001)，和24个月(85%vs.63%；p=0.07）。在各种亚组比较中，C组手术的成功率也高于D组手术。C组在术前至随访期间的ODI下降幅度大于D组[绝对变化(%变化),（p）]：6个月：-35（-61%）对-23（-39%），（p<0.05）；12个月：-39（-69%）对-22（-39%），(p<0.01)；24个月：-38(-66%)对-26(-48%)，(p<0.05)。
结论：更成功，通过NOCISCAN-LS后处理椎间盘MRS检查确定的化学疼痛性椎间盘手术治疗可获得持续结局.结果表明，NOCISCAN-LS提供了一种有价值的新诊断工具，可以帮助临床医生更好地选择治疗水平。
