2004 Young Investigator Award winner: Vertebral endplate marrow contact channel occlusions and intervertebral disc degeneration
2004 Young Investigator Award winner: Vertebral endplate marrow contact channel occlusions and intervertebral disc degeneration
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DOI：
10.1097/01.brs.0000150833.93248.09
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发表时间：
2005-01-15
期刊：
影响因子：
3
通讯作者：
Ito, K
中科院分区：
文献类型：
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作者：
Benneker, LM;Heini, PF;Ito, K
研究设计.椎间盘退变通过形态学表现、磁共振成像和生化基质成分进行评价。测量相邻椎体骨终板开口的口径和分布。椎体终板开口闭塞与椎间盘退变之间的相关性被量化。随着疾病和年龄的增长，椎体终板的钙化表明营养不足是椎间盘退变的一种机制。已经提出，终板开口的闭塞，其中包含椎间盘的血管来源，可能会限制营养物质的运输，导致椎间盘退变。新鲜的磁共振图像从39人腰椎间盘进行了评分。对带终板的椎间盘切片进行形态学分级。核和环状区域的样品进行了蛋白多糖和胶原含量的评价。获得4个终板区域的背光显微镜图像，并测量每个椎间盘的终板开口的口径和分布。方差分析回归模型用于评估终板开口和椎间盘退变之间的相关性。开口密度的降低与形态学退变程度显著相关，最好是在核区的等效直径为20至50 μ m的开口。虽然20至50 im开口的密度也与年龄有显著的间接相关性，但其与退行性分级的相关性不强。开口密度也显着相关的蛋白多糖含量在所有地区。然而，所有其他生化参数以及T2强度评分仅显示与开口密度弱相关或无相关性。骨终板开口密度（特别是毛细血管芽的大小）与椎间盘形态学退变程度之间的高度间接相关性支持了这样一种假设，即这些开口的闭塞可能会剥夺细胞的营养，导致细胞外基质的维持不足和椎间盘退变。
Study Design. Intervertebral disc degeneration was evaluated by morphologic appearance, magnetic resonance imaging, and by biochemical matrix composition. Caliber and distribution of openings of the adjacent vertebral osseous endplates were measured.Objectives. Correlation between occlusion of vertebral endplate openings and intervertebral disc degeneration was quantified.Summary of Background Data. Calcifications of vertebral endplates with disease and age have suggested insufficient nutrition as a mechanism for intervertebral disc degeneration. It has been proposed that occlusion of endplate openings, which contain vascular sources for the disc, may limit the transport of nutrients, leading to disc degeneration.Methods. Fresh magnetic resonance images from 39 human lumbar discs were scored. Sectioned discs with endplates were morphologically graded. Samples of nuclear and anular regions were evaluated for proteoglycan and collagen contents. Backlight microscopic images of 4 endplate regions were obtained, and caliber and distribution of endplate openings for each disc were measured. Analysis of variance regression models were used to assess correlation between endplate openings and disc degeneration.Results. The decrease in opening density significantly correlated to morphologic degeneration grade, best for openings with 20 to 50 im equivalent diameter and in the nuclear region. Although the density of 20 to 50 im openings also significantly indirectly correlated to age, it was not as strong as the correlation to degeneration grade. Opening density was also significantly correlated to proteoglycan content in all regions. However, all other biochemical parameters as well as the T2 intensity score showed only weak or no correlation to opening density.Conclusions. A high indirect correlation between the density of openings in the osseous endplate (particularly of the size of the capillary buds) and the morphologicdegeneration grade of the disc support the hypothesis that occlusion of these openings may deprive the cells of nutrients, leading to insufficient maintenance of the extracellular matrix and disc degeneration.