Presenting at the World Forum for Spine Research 2012

​Interview with AO Research Institute Davos Borthakur who is investigating degeneration and regeneration of the intervertebral disc.

20 October 2011

Dr Borthakur presenting at the Global Spine Congress San Francisco 2009

The World Forum for Spine Research 2012 will focus on the intervertebral disc (IVD)—from degeneration to pain. AO Research Institute Davos Borthakur, Assistant Professor of Radiology at the University of Pennsylvania School Of Medicine, is part of AO Spine's Research Network (SRN) investigating degeneration and regeneration of the IVD. He is one of the faculties on the session: Diagnostics: What's new? with the presentation on Biomarkers.

Borthakur is a researcher, developing MRI technology for application in the diagnosis of early disc degeneration on patients with low back pain. His background is in physics and MRI –an imaging technology that is commonly used to diagnose diseases.

Talking about his work, he says: There are some limitations in terms of detecting early degeneration of the disc. What we mean by early degeneration in this case is changes in the biochemical composition of the disc itself. We're specifically targeting the changes in the glycosaminoglycan or GAG content in the disc. We have method called T1ρ MRI, which we have been using for many years now to show that the MRI signal from a T1ρ MRI image is directly related to the GAG content in the disc.


He continues: The GAG needs to be measured as it is known as being responsible for the osmotic pressure in the nucleus of the disc. That pressure, under normal conditions, allows the disc to maintain its normal compressibility. However, with degeneration, there's a loss of GAG. As a consequence there's also a loss in the hydration of the disc itself. As we can see in a conventional MRI, the degeneration in the disc becomes dark, which is due to the loss of hydration, but also the disc loses its structural integrity and eventually collapses or herniates. This is the cascade of events, which is called disc-generative disease, and is one of the main causes of low back pain in people.

AO Spine: Mr. Borthakur, is this research being conducted with patients?

AO Research Institute Davos Borthakur: All of my research goes from development directly to clinical research in patients. I have an AO Spine funded grant, which has allowed me to make these measurements in patients with low back pain that are about to undergo either arthroplasty or fusion surgery. In my five years of study, I perform T1ρ MRI in these people before their surgery. I follow it up again in two or three years to see if the adjacent level discs have been generated due to the surgical intervention, which is actually a big question for surgeons to know.

How many patients are you working with?

90 patients from Pennsylvania Hospital, Philadelphia, USA.

When did you get the AO Spine grant?

In 2007, it ends in 2012.

How do you feel AO Spine can grow in North America?

I think there's a lot of opportunity here. I got to know of AO Spine when I applied for the grant in 2007. Since then, I see the number of participants growing with each meeting I attend. AO Spine is highly respected in my community of researchers. I also think there's potential for including not only clinical researchers like myself, but other basic scientists as well that are working in the orthopedic arena. I think there's room for growth there.

You are faculty during the World Forum for Spine Research 2012 in Helsinki with a presentation on Biomarkers. Can you tell us about your presentation and why participants should attend it?

I will have exciting new results from the 5-year AO Spine sponsored study. In particular, clinicians treating disc degeneration would be interested in knowing the effect of surgical intervention (fusion vs. arthroplasty) with regard to adjacent level disc disease. I will also present new MRI biomarkers that we have developed during this time. ​​​​​​​​​​​​​

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