Methods to diagnose degenerative disc disease

Abstract

Methods are provided that better describe, and localize the pain generator or suspected pain generator in and around spinal discs in relation to neck or back pain so as to improve the diagnosis of degenerative disc disease. In some embodiments, there are methods for diagnosing a pain generator or a suspected pain generator in a patient suffering from back pain, the methods comprise labeling an inflammatory, vascular, neuronal, and/or metabolic pain marker at a location inside of or adjacent to an intervertebral disc in the patient suffering from back pain to increase an image of the pain marker with an imaging procedure; and imaging the labeled inflammatory, vascular, neuronal, and/or metabolic pain marker in a manner sufficient to diagnose the pain generator or suspected pain generator.

1 . A method for diagnosing a pain generator or a suspected pain generator in a patient suffering from neck or back pain, the method comprising labeling an inflammatory, vascular, neuronal, and/or metabolic pain marker at a location inside of or adjacent to an intervertebral disc in the patient suffering from back pain, allowing the labeled inflammatory, vascular, neuronal, and/or metabolic pain marker to bind the pain generator or suspected pain generator; and imaging the labeled inflammatory, vascular, neuronal, and/or metabolic pain marker bound to the pain generator or suspected pain generator in a manner sufficient to diagnose the pain generator or suspected pain generator. 
     
     
         2 . (canceled) 
     
     
         3 . A method according to  claim 1 , wherein the labeled inflammatory, vascular, neuronal, and/or metabolic pain marker comprises at least one muscle, ligament, tendon, cartilage, nerve, spinal disc, spinal foraminal space near the spinal nerve root, facet or spinal canal. 
     
     
         4 . A method according to  claim 1 , wherein the labeled inflammatory, vascular, neuronal, and/or metabolic pain marker comprises a substance associated with a nerve fiber or a cellular structure associated with the nerve fiber. 
     
     
         5 . A method according to  claim 1 , wherein the labeled inflammatory, vascular, neuronal, and/or metabolic pain marker comprises an inflammatory or proinflammatory factor. 
     
     
         6 . A method according to  claim 1 , wherein the labeled inflammatory, vascular, neuronal, and/or metabolic pain marker comprises a leukocyte. 
     
     
         7 . A method according to  claim 1 , wherein the labeled inflammatory, vascular, neuronal, and/or metabolic pain marker comprises a cytokine. 
     
     
         8 . A method according to  claim 1 , wherein the labeled inflammatory, vascular, neuronal, and/or metabolic pain marker comprises nerve growth factor, vascular endothelial growth factor, IL-1, IL-6, or IL-8. 
     
     
         9 . A method according to  claim 1 , wherein the labeled inflammatory, vascular, neuronal, and/or metabolic pain marker is labeled by an antibody that binds the pain generator or suspected pain generator. 
     
     
         10 . A method according to  claim 1 , wherein the labeled inflammatory, vascular, neuronal, and/or metabolic pain marker comprises [18F] FDG (2′-deoxy-2′-fluro-D-glucose) or [18F] 1-(3-fluoropropyl)-4-(4-cyanophenoxymethyl) piperidine or [18F] AH-111585. 
     
     
         11 . A method for diagnosing a pain generator or a suspected pain generator in a patient suffering from degenerative disc disease, the method comprising determining an amount of labeled inflammatory, vascular, neuronal, and/or metabolic pain marker in a location inside of or adjacent to an intervertebral disc in the patient suffering from degenerative disc disease; and comparing the amount of labeled inflammatory, vascular, neuronal, and/or metabolic pain marker in a location inside of or adjacent to an intervertebral disc to a normal range of the labeled pain marker inside of or adjacent to an intervertebral disc, wherein the amount of the labeled pain marker outside of the normal range indicates the location of the pain generator or suspected pain generator. 
     
     
         12 . (canceled) 
     
     
         13 . (canceled) 
     
     
         14 . A method according to  claim 11 , wherein the labeled inflammatory, vascular, neuronal, and/or metabolic pain marker is associated with a nerve fiber or a cellular structure associated with the nerve fiber. 
     
     
         15 . A method according to  claim 11 , wherein the labeled inflammatory, vascular, neuronal, and/or metabolic pain marker comprises an inflammatory factor. 
     
     
         16 . A method according to  claim 11 , wherein the labeled inflammatory, vascular, neuronal, and/or metabolic pain marker comprises a leukocyte. 
     
     
         17 . A method for diagnosing a pain generator or a suspected pain generator in a patient suffering from neck or back pain, the method comprising administering a diagnostic agent that specifically binds to an inflammatory, vascular, neuronal, and/or metabolic pain marker at a location inside of or adjacent to an intervertebral disc in the patient suffering from back pain; allowing the labeled inflammatory, vascular, neuronal, and/or metabolic pain marker to specifically bind to the pain generator or suspected pain generator; and imaging the bound labeled inflammatory, vascular, neuronal, and/or metabolic pain marker in a manner sufficient to diagnose the pain generator or suspected pain generator. 
     
     
         18 . A method according to  claim 17 , wherein the labeled inflammatory, vascular, neuronal, and/or metabolic pain marker comprises 18F FDG (2′-deoxy-2′-fluro-D-glucose) or 18F 1-(3-fluoropropyl)-4-(4-cyanophenoxymethyl) piperidine or [18F] AH-111585. 
     
     
         19 . A method according to  claim 17 , wherein the diagnostic agent is administered by intravenous, intramuscular, intrathecal, subcutaneous, epidural, intra-discal, peridiscal, peridural, perispinal administration or a combination thereof. 
     
     
         20 . (canceled)