Early disc degeneration in radiotherapy-treated childhood brain tumor survivors
Grahn, Petra; Remes, Tiina; Kivisaari, Reetta; Suo-Palosaari, Maria H.; Arikoski, Pekka M.; Koskenkorva, Päivi K. T.; Lähteenmäki, Päivi M.; Lönnqvist, Tuula R. I.; Ojaniemi, Marja K.; Sirkiä, Kirsti H.; Sutela, Anna K.; Toiviainen-Salo, Sanna-Maria; Rantala, Heikki M. J.; Harila, Arja H.; Niinimäki, Jaakko; Karppinen, Jaro; Ahonen, Matti (2023-05-31)
Grahn, P., Remes, T., Kivisaari, R. et al. Early disc degeneration in radiotherapy-treated childhood brain tumor survivors. BMC Musculoskelet Disord 24, 441 (2023). https://doi.org/10.1186/s12891-023-06509-4
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https://urn.fi/URN:NBN:fi-fe20230920133860
Tiivistelmä
Abstract
Background: Childhood brain tumor (BT) survivors have an increased risk of treatment-related late effects, which can reduce health-related quality of life and increase morbidity. This study aimed to investigate lumbar disc degeneration in magnetic resonance imaging (MRI) in adult survivors of radiotherapy-treated childhood BT compared to age and sex-matched population controls.
Methods: In this cross-sectional comparative study, 127 survivors were identified from hospital registries. After a mean follow-up of 20.7 years (range 5–33.1), 67 survivors (mean age 28.4, range 16.2–43.5) were investigated with MRI and compared to 75 sex-matched population-based controls. Evaluated MRI phenotypes included Pfirrmann grading, intervertebral disc protrusions, extrusions, and high-intensity-zone-lesions (HIZ). Groups were also compared for known risk factors of lumbar intervertebral disc (IVD) degeneration.
Results: Childhood BT survivors had higher Pfirrmann grades than controls at all lumbar levels (all p < 0.001). Lumbar disc protrusions at L4-5 (p = 0.02) and extrusions at L3-4 (p = 0.04), L4-5 (p = 0.004), and L5-S1 (p = 0.01) were significantly more common in the BT group compared to the control. The survivor cohort also had significantly more HIZ-lesons than the controls (n=13 and n=1, p=0.003). Age at diagnosis was associated with lower degree of IVD degeneration (p < 0.01). Blood pressure correlated with IVD degeneration (P < 0.05).
Conclusions: Signs of early disc degeneration related to tumor treatment can be seen in the IVDs of survivors. Disc degeneration was more severe in children treated in adolescence.
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