Graduate Thesis Or Dissertation


Precision Medicine for the Intervertebral Disc: Image Processing and Computational Modeling of Disc Degeneration to Inform Patient-Specific Therapies Public Deposited

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  • The human intervertebral disc is a deceptively simple structure which plays an essential role in human movement. Even slight changes to the disc microenvironment can have far reaching consequences, particularly when these changes result in disc degeneration and herniation. Degeneration is increasingly tied to lower back pain; better understanding this complex relationship could enable more informed treatments and better outcomes for patients suffering from low back pain. The overall aim of the work presented here is to investigate tools and techniques which might aid in patient evaluation, for use in both research and clinical settings. Specifically, this includes (1) development of a patient-specific finite element model of nutrient transport in the disc, and (2) quantitative comparison of a novel imaging modality (apparent diffusion coefficient mapping) to established modalities for disc visualization. In the first investigation, results of the patient-specific model showed distinct diffusion behavior between patients, even within discs of the same degeneration grade, indicating the importance of the patient-specific diffusivities to the accurate prediction of nutrient availability in the disc. In the second investigation, the results indicated a general sensitivity of both modalities to degeneration of the NP. However, significant differences were found between the modalities at measuring the same features, indicating that the two modalities have fundamentally different capabilities for IVD visualization and implying that one is more accurate than the other. Validating this will be the focus of future work.
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