Is bone density associated with intervertebral disc pressure in healthy and degenerated discs?
Is bone density associated with intervertebral disc pressure in healthy and degenerated discs?
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DOI：
10.1016/j.jbiomech.2017.08.033
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发表时间：
2017-11-07
影响因子：
2.4
通讯作者：
Morgan, Elise F.
中科院分区：
文献类型：
--
作者：
Fein, Paul M.;DelMonaco, Alexander;Morgan, Elise F.
椎间盘（IVD）和椎骨作为生物力学单元的耦合表明，椎间盘退变导致的IVD内压力分布（椎间盘内压力，IDP）的变化会影响椎骨内骨密度的分布，反之亦然。本研究的目的是评估相邻椎骨中IDP和骨密度之间的对应关系，重点是健康和退化IVD之间的对应关系如何不同。通过定量计算机断层扫描（QCT）测量了61个脊柱节段（T7- 9，19 - 11，110 -12：71 +/- 14岁）中前后纤维环（分别为aAF和pAF）和髓核（NP）附近区域终板和软骨下骨的骨密度。IDP测量的aAF，NP，和pAF地区的26个脊柱节段（68 - 16岁），而他们在弯曲（5）或直立姿势进行测试。通过多个分级方案评估椎间盘退变。两种体位的骨密度与IDP之间均无相关性（p > 0.104）。发现随着退变的进展，1DP的区域变化以及更大程度上的骨密度发生变化：相对于aAF区域，NP区域的IDP（p = 0.045）和骨密度（p = 0.024）均降低。IDP和骨密度的退行性相关变化之间仅存在适度的对应关系，这可能是由于IDP如何与通过终板的机械力传递相关的复杂性以及现有IVD分级方案在估计IVD机械行为方面的局限性。(C)2017爱思唯尔有限公司版权所有。
The coupling of the intervertebral disc (IVD) and vertebra as a biomechanical unit suggests that changes in the distribution of pressure within the 1VD (intradiscal pressure, IDP) as a result of disc degeneration can influence the distribution of bone density within the vertebra, and vice versa. The goal of this study was to assess the correspondence between IDP and bone density in the adjacent vertebrae, with emphasis on how this correspondence differs between healthy and degenerated IVDs. Bone density of the endplates and subchondral bone in regions adjacent to the anterior and posterior annulus fibrosus (aAF and pAF, respectively) and nucleus pulposus (NP) was measured via quantitative computed tomography (QCT) in 61 spine segments (T7-9,19-11,110-12: 71 +/- 14 years). IDP was measured in the aAF, NP, and pAF regions in 26 of the spine segments (68 16 years) while they were tested in flexed (5) or erect postures. Disc degeneration was assessed by multiple grading schemes. No correlation was found between bone density and IDP in either posture (p > 0.104). Regional variations in 1DP and, to a greater extent bone density, were found to change with advancing degeneration: both IDP (p = 0.045) and bone density (p = 0.024) decreased in the NP region relative to the aAF region. The finding of only a modest correspondence between degeneration-associated changes in IDP and bone density may arise from complexity in how IDP relates to mechanical force transmission through the endplate and from limitations of the available IVD grading schemes in estimating the mechanical behavior of the IVD. (C) 2017 Elsevier Ltd. All rights reserved.