Disc degenerative changes are directly or indirectly associated with spinal pain and disability. Literature revealed a high prevalence of disc degeneration in the thoracic region, however thoracic MRI degeneration trends and information on disc biochemical matrix constituents are limited for thoracic discs compared to lumbar and cervical discs. The objective of this thesis was to use MRI to investigate the prevalence of disc degenerative changes affecting the human thoracic spine, and to determine the factors affecting spinal disc biochemical matrix. A 3-point subjective MRI grading scale was used to grade the films. The feasibility of using archived formalin-fixed cadaver material was investigated to analyse collagen and elastin crosslinks. The prevalence of degenerative changes in human thoracic discs and vertebrae (T1 to T12) was determined retrospectively from an audit of 216 MRI cases, using sagittal T1- and T2-weighted MR images. In a subsequent series of ex-vivo studies, human thoracic discs and LF from 26 formalin-fixed and two fresh spines, involving all thoracic levels, were examined macroscopically to determine the degeneration status. Subsequently, disc and ligament tissues were analysed biochemically for collagen (pyridinoline and deoxypyridinoline) and elastin (desmosine and isodesmosine) crosslinks. These crosslinks were extracted from hydrolysed samples by cellulose partition chromatography, and analysed by reverse-phase HPLC. Collagen content was determined using its hydroxyproline content, and proteoglycan content was assayed using a modified DMB assay for chondroitin sulphate. Finally the MRI and macroscopic assessments of thoracic discs, were compared with the biochemical data from two fresh cadaver thoracic spines. The 3-point MRI grading scale had a high inter- (k = 0.57 to 0.78) and intra-rater (k = 0.71 to 0.87) reliability. There were no significant differences in the collagen and elastin content and extent of collagen crosslinks between formalin fixed and unfixed ligament and disc tissues, after 25 weeks of formalin fixation. From the in-vivo MRI series of investigations (n = 216 MRI films), the prevalence of thoracic disc degenerative and vertebral morphological changes revealed significant age, gender and spinal level trends (p < 0.05).Generally, males had a higher propensity for disc degeneration in contrast to females, especially older females, where the trend showed a higher prevalence of osteophytes and vertebral body changes. In particular, the mid and lower thoracic levels have a higher prevalence of degenerative changes, except for osteophytes and anterior vertebral wedging. With increased age, there was a concomitant increase in anterior wedging and bi-concavity and disc degenerative changes except for end-plates. The biochemical investigations on the ex-vivo series of formalin-fixed thoracic discs (n = 303) also revealed significant changes in the disc matrix due to degeneration status, age, gender and spinal regional factors. With increased age, normal disc matrices have significantly lower collagen content and extent of pyridinoline (p < 0.001). In contrast, the degenerated disc matrix revealed significantly higher collagen content and extent of deoxypyridinoline (p < 0.05). These findings suggest that an altered matrix existed in normal ageing discs, which render the disc prone to injury and degeneration over the life span. The higher collagen and deoxypyridinoline in degenerated disc matrices reflects an increase in chondrocyte synthesis, and is also a novel finding, suggesting that they may be used as markers of ageing and degeneration processes. The biochemical investigations on another series of ex-vivo spinal LF tissues (n = 364), revealed that this had a lower collagen and pyridinoline, but significantly higher elastin and deoxypyridinoline compared to spinal discs (p < 0.05). Elastin crosslinks however were difficult to detect in spinal discs, being present in negligible amounts in a few lumbar discs. The elastin crosslinks in the LF were not significantly affected by age, but were significantly higher in calcified, and female ligamentum tissues, and also in the lumbar region (p < 0.05). These MRI prevalence findings enhanced our knowledge of vertebral body and disc degeneration trends in the thoracic region and contributed to the interpretation of MR images for pathology in the human thoracic spine. Information on the associated collagenous and elastic changes in the disc and ligamentum matrices provide original data and insight on the pathogenesis of degeneration in the disc matrix from a biochemical perspective, highlighting gender, age and spinal level influences on the matrix tensile strength and cellular synthetic activities.

Le collagène de type I osseux subit une série de modifications post-traductionnelles au cours du processus de maturation. Un certain nombre de ces modifications sont quantifiables par dosage : c’est le cas des molécules de pontage enzymatiques pyridinoline (PYD) et désoxypyridinoline (DPD), de la pentosidine (PEN) qui est un produit de glycation, et de la forme native (α) et isomérisée (β) des C-télopeptides (α et β CTX) du collagène de type I. A l’aide d’un modèle de maturation in vitro d’os bovin foetal, nous avons montré que le taux de solubilisation du collagène osseux par la cathepsine K augmente avec la durée d’incubation des os à 37°C. Nous avons également montré que cette augmentation est corrélée au taux des modifications post-traductionnelles du collagène mesurées. Lors d’une étude précédente utilisant ce même modèle de maturation d’os foetal, nous avions déterminé que les modifications post-traductionnelles du collagène osseux influençaient les propriétés mécaniques de l’os. Dans le cadre de ce travail de thèse et pour compléter cette étude, nous avons mis au point un modèle pour étudier isolément l’influence des molécules de pontage PYD et DPD sur les propriétés mécaniques de l’os. Ce modèle utilise de l’os cortical bovin traité aux U.V. puis soumis à des tests de flexion trois points. Dans la même optique, nous avons contribué à la mise au point d’un dosage en chromatographie en phase liquide à haute performance qui permet de quantifier à la fois les formes matures et immatures des molécules de pontage pyridinoliques (PYD, DPD, HLNL et DHLNL) sur le même chromatogramme / Type I bone collagen undergoes a series of posttranslational modifications during maturation process. Some of them are quantifiable by assays: the enzymatic cross-links pyridinoline (PYD) and deoxypyridinoline (DPD), the advanced glycation end product pentosidine (PEN), and the native (α) and isomerized (β) forms of the type I collagen C-telopeptides (α and β CTX). With an in vitro model of bovine fetal bone maturation, we showed that bone collagen solubilization by cathepsin K increases with the duration of bone incubation at 37°C. We also showed a correlation between this increase of solubilization and the level of measured collagen posttranslational modifications. In a previous study, using the same fetal bovine bone maturation, our results had suggested a link between bone collagen posttranslational modifications and bone mechanical properties. In the aim to complete this study, we developed a model to focus on PYD and DPD influence in bone mechanical properties. This model uses bovine cortical bone subjected to ultraviolet light before three points binding tests. In the same purpose, we contributed to develop a High-Performance Liquid Chromatography essay, quantifying mature and immature forms of pyridinium crosslinks (PYD, DPD, HLNL and DHLNL) in an unique chromatogram