Modifications in Lumbar Endplate Space and Concavity Related With Disc Degeneration.
Backbone (Phila Pa 1976). 2018 Mar 27;:
Authors: Louie PK, Espinoza Orías AA, Fogg LF, LaBelle M, An HS, Andersson GBJ, Inoue N
STUDY DESIGN: Retrospective image-based evaluation.
OBJECTIVE: To measure endplate three-dimensional (3D) geometry, endplate modifications in vivo and to analyze correlations between disc degeneration and endplate 3D geometry depending on signs of low again ache (LBP).
SUMMARY OF BACKGROUND DATA: It has been hypothesized that alteration of load transmission from the nucleus pulposus to the annulus fibrosus impacts vertebral endplate geometry.
METHODS: 3D floor fashions of inferior/superior lumbar endplates had been created from computed tomography scans of n?=?92 volunteers with and with out LBP. Disc degeneration was evaluated utilizing Pfirrmann scale. Concavity in each coronal and sagittal planes was assessed with the Concavity Index (unitless; bigger than 1: concave; flat: 1; and fewer than 1: convex, respectively). Endplate space and disc peak distribution had been computed and the results from demographics and spinal degeneration had been sought with an evaluation of variance mannequin.
RESULTS: Each sagittal and coronal planes revealed considerably decreased concavity in these with terminal grade 5 disc degeneration (imply zero.833?±?zero.235) in comparison with the opposite grades within the cohort. Older topics offered with bigger endplate areas than the youthful topics (P?=?zero.0148) at L4-S1. General, symptomatic topics had considerably bigger endplate areas (P?=?zero.022), particularly on the decrease lumbar ranges (P?<?zero.001). Evaluation of variance confirmed that intercourse, disc stage, disc degeneration grade, and disc peak reached significance (P?<?zero.0001) as influential parameters in each Concavity Index circumstances.
CONCLUSION: With advancing intervertebral disc degeneration, endplates change into extra convex over time in each sagittal and coronal planes. Our findings implicate the endplate modifications with advancing disc degeneration within the shift in load transmission from the nucleus pulposus to the annulus fibrosus, leading to modifications throughout the curvature of the endplates. That is additionally the primary examine to explain the direct affect of age, intercourse, and LBP on vertebral endplate anatomy.
LEVEL OF EVIDENCE: 5.
PMID: 29596278 [PubMed – as supplied by publisher]