Cervical Disc Degeneration and Vertebral Endplate Defects After the Fused Operation

Purpose The aim of this study was to evaluate the association between vertebral endplate morphology and the degree of lumbar intervertebral disc degeneration via magnetic resonance imaging (MRI). Methods In total, 150 patients who met the inclusion criteria and were 20–60 years of age were retrospectively evaluated. Patients were evaluated for the presence of intervertebral disc degeneration or herniation, and the degree of degeneration was assessed at all lumbar levels. Vertebral endplate morphology was evaluated based on the endplate sagittal diameter, endplate sagittal concave angle (ECA), and endplate sagittal concave depth (ECD) on sagittal MRI. The association between intervertebral disc degeneration or herniation and endplate morphological measurements was analysed. Results In MRI, superior endplates ( ie, inferior endplates of the superior vertebra) were concave and inferior endplates ( ie, superior endplates of the inferior vertebra) were flat at all disc levels. A decrease in ECD and an increase in ECA were detected at all lumbar levels as disc degeneration increased ( P < .05). At the L4-L5 and L5-S1 levels, a decrease in ECD and an increase in ECA were detected in the group with herniated lumbar discs ( P < .05). There was no association between lumbar disc degeneration or herniation and endplate sagittal diameter at lumbar intervertebral levels ( P > .05). At all levels, ECD of women was significantly lesser than that of men and ECA of women was significantly greater than that of men ( P < .05). Conclusions There is an association between vertebral endplate morphology and lumbar intervertebral disc degeneration. Vertebral endplates at the degenerated disc level become flat; the severity of this flattening is correlated with the degree of disc degeneration.

Download Full-text

The biomechanical effects of S-type dynamic cage using Ti and PEEK for ACDF surgery on cervical spine varying loads

The International Journal of Artificial Organs ◽

10.1177/03913988211039525 ◽

2021 ◽

pp. 039139882110395

Author(s):

Pechimuthu Susai Manickam ◽

Sandipan Roy

Keyword(s):

Disc Degeneration ◽

Lower Risk ◽

Mechanical Stability ◽

Early Stage ◽

Cervical Disc ◽

Adjacent Segment ◽

Stress Profile ◽

Fe Model ◽

Cage Subsidence ◽

Adjacent Disc

Anterior cervical discectomy with fusion (ACDF) is the common method to treat the cervical disc degeneration. The most serious problems in the fusion cages are adjacent disc degeneration, loss of lordosis, pain, subsidence, and migration of the cage. The objective of our work is to develop the three-dimensional finite element (FE) model from C3-C6 and virtually implant a designed S-type dynamic cage at C4-C5 segment of the model. The dynamic cage design will provide mobility in the early stage after ACDF surgery. Titanium (Ti) and PEEK (polyether ether ketone) were used as the material property for the cages. We applied the physiological motions at different loads from 0.5, 1, 1.5, 2.0 Nm to evaluate the dynamic cage design and the biomechanical performances of the designed S-type dynamic cage. It was observed that in all the loading condition the range of motion in the adjacent level was maintained and the maximum stress at the adjacent disc was reduced. The clinical significance of the S-type dynamic cage is better stress profile at the fusion level and adjacent segments which translates into higher rate of fusion, lower risk of cage subsidence, lower risk of adjacent segment degeneration, and good mechanical stability.

Download Full-text

Prevalence, Patterns, and Genetic Association Analysis of Modic Vertebral Endplate Changes

Asian Spine Journal ◽

10.4184/asj.2017.11.4.594 ◽

2017 ◽

Vol 11 (4) ◽

pp. 594-600 ◽

Cited By ~ 9

Author(s):

Rishi Mugesh Kanna ◽

Rajasekaran Shanmuganathan ◽

Veera Ranjani Rajagopalan ◽

Senthil Natesan ◽

Raveendran Muthuraja ◽

...

Keyword(s):

Candidate Genes ◽

Genetic Association ◽

Association Analysis ◽

Disc Degeneration ◽

Lumbar Disc ◽

Nucleotide Polymorphisms ◽

Lumbar Disc Degeneration ◽

Vertebral Endplate ◽

Genetic Association Analysis ◽

Study Population

<sec><title>Study Design</title>A prospective genetic association study.</sec><sec><title>Purpose</title>The etiology of Modic changes (MCs) is unclear. Recently, the role of genetic factors in the etiology of MCs has been evaluated. However, studies with a larger patient subset are lacking, and candidate genes involved in other disc degeneration phenotypes have not been evaluated. We studied the prevalence of MCs and genetic association of 41 candidate genes in a large Indian cohort.</sec><sec><title>Overview of Literature</title>MCs are vertebral endplate signal changes predominantly observed in the lumbar spine. A significant association between MCs and lumbar disc degeneration and nonspecific low back pain has been described, with the etiopathogenesis implicating various mechanical, infective, and biochemical factors.</sec><sec><title>Methods</title>We studied 809 patients using 1.5-T magnetic resonance imaging to determine the prevalence, patterns, distribution, and type of lumbar MCs. Genetic association analysis of 71 single nucleotide polymorphisms (SNPs) of 41 candidate genes was performed based on the presence or absence of MCs. SNPs were genotyped using the Sequenome platform, and an association test was performed using PLINK software.</sec><sec><title>Results</title>The mean age of the study population (n=809) was 36.7±10.8 years. Based on the presence of MCs, the cohort was divided into 702 controls and 107 cases (prevalence, 13%). MCs were more commonly present in the lower (149/251, 59.4%) than in the upper (102/251, 40.6%) endplates. L4–5 endplates were the most commonly affected levels (30.7%). Type 2 MCs were the most commonly observed pattern (n=206, 82%). The rs2228570 SNP of VDR (<italic>p</italic>=0.02) and rs17099008 SNP of MMP20 (<italic>p</italic>=0.03) were significantly associated with MCs.</sec><sec><title>Conclusions</title>Genetic polymorphisms of SNPs of VDR and MMP20 were significantly associated with MCs. Understanding the etiopathogenetic mechanisms of MCs is important for planning preventive and therapeutic strategies.</sec>

Download Full-text

Cervical disc degeneration and neck pain

Journal of Pain Research ◽

10.2147/jpr.s180018 ◽

2018 ◽

Vol Volume 11 ◽

pp. 2853-2857 ◽

Cited By ~ 12

Author(s):

Baogan Peng ◽

Michael J DePalma

Keyword(s):

Neck Pain ◽

Disc Degeneration ◽

Cervical Disc

Download Full-text

Reactive changes in the adolescent porcine spine with disc degeneration due to endplate injury

Veterinary and Comparative Orthopaedics and Traumatology ◽

10.1055/s-0037-1616581 ◽

2007 ◽

Vol 20 (01) ◽

pp. 12-17 ◽

Cited By ~ 11

Author(s):

A. Baranto ◽

A. Kaigle Holm ◽

L. Ekström ◽

L. Swärd ◽

T. Hansson ◽

...

Keyword(s):

Blood Vessels ◽

Nucleus Pulposus ◽

Disc Degeneration ◽

Annulus Fibrosus ◽

Scar Tissue ◽

Vertebral Endplate ◽

Lumbar Intervertebral Disc ◽

Physiological Loading ◽

Reactive Changes ◽

Chronic Inflammatory Reaction

SummaryDegenerative and reactive structural alterations occurring after experimentally-induced disc degeneration were evaluated using a porcine model. A cranial perforation was made through the L4 vertebral endplate into the nucleus pulposus. Three months later, the lumbar intervertebral disc and adjacent vertebrae were dissected, fixed in formalin and further processed for histopathological analyses. The results showed that there were nucleus pulposus fragments, rather than a distinct border between the nucleus and annulus fibrosus. The central lamellae were distorted and delamination of the outer anterior layers was observed. Blood vessels emerged from the adjacent tissue, penetrated the annulus and branched into the residues of the nucleus. Nerve fibres accompanying the blood vessels could be recognized in the disc within the connective scar tissue. The epiphyseal cartilage plates in the vertebrae were hypertrophic in several areas and there was bone formation directed towards the centre of the vertebral body and the disc. Hypertrophic hyaline cartilage, newly formed bone and scar tissue filled the injury canal. A slight chronic inflammatory reaction was evident along vascular buds. The reactive changes dominated over the degenerated features in the operated disc. Physiological loading enhanced the infiltration of various tissue types characterizing immature cartilage formation. Prominent neovascularisation of the central parts of the disc is likely to be of key importance in turning the degenerative features of the remaining tissue into reactive healthy structures.

Download Full-text

ISSLS prize winner: Lumbar vertebral endplate lesions: associations with disc degeneration and back pain history. Wang Y, Videman T, Battié MC. Spine (Phila Pa 1976) 2012;37(17):1490–6.

The Spine Journal ◽

10.1016/j.spinee.2013.02.022 ◽

2013 ◽

Vol 13 (3) ◽

pp. 364

Keyword(s):

Back Pain ◽

Disc Degeneration ◽

Vertebral Endplate ◽

Pain History

Download Full-text

The Natural History of Severe Cervical Disc Degeneration

Acta Orthopaedica Scandinavica ◽

10.3109/17453677208998959 ◽

1972 ◽

Vol 43 (5) ◽

pp. 392-396 ◽

Cited By ~ 11

Author(s):

A. F. Depalma ◽

R. H. Rothman ◽

R. L. Levitt ◽

N. L. Hammond

Keyword(s):

Natural History ◽

Disc Degeneration ◽

Cervical Disc ◽

History Of

Download Full-text

Analysis of Risk Factors for Spinal Pain: A Case Control Study of New Graduate Aviators Based on Imaging and Questionnaire Results.

10.21203/rs.3.rs-78076/v1 ◽

2020 ◽

Author(s):

Fang Xie ◽

Yachao Ma ◽

Zhipeng Tu ◽

Peipei Huang ◽

Zhe Wang ◽

...

Keyword(s):

Risk Factors ◽

Disc Degeneration ◽

Lumbar Disc ◽

Multivariate Logistic Regression Analysis ◽

Spinal Pain ◽

Degenerative Changes ◽

Cervical Disc ◽

Lumbar Disc Degeneration ◽

Disc Protrusion ◽

New Graduate

Abstract Background: Disc degenerative diseases are common in occupational aviators exposed to long flight time and vibration during flight. The incidence of pathological and degenerative changes of spine in experienced pilots are widely studied and reported. However, few literatures focused on new graduate aviators. In this study we intended to describe imaging features of spine in new graduate aviators from flight academy and analyzed the risk factors for spinal pain.Methods: This is a retrospective study of 178 new graduate aviators. All received full-length lateral X-ray of spine and 1.5T magnetic resonance imaging (MRI) of cervical and lumbar spine. Sagittal alignments were measured through X-ray imaging. The degenerative grade of disc was defined according to Miyazaki and Pfirrmann grading classifications. The prevalence of degenerative disc diseases was reported under disc nomenclatures. The incidence of spinal pain during the last 12 months of flight training was acquired from questionnaires. Multivariate logistic regression analysis was utilized to analyses risk factors for spinal pain.Results: The whole cohort presented at least one level disc degeneration of Grade 2 in cervical or lumbar spine. 134 of 178 subjects (75.3%) showed at least one cervical disc degeneration in grade 3. 61 (34.3%) presented cervical disc bulging and 5 (3%) presented cervical disc protrusion. 110 (61.8%) aviators reported neck pain during the last 12 months. 53 of 178 (29.8%) volunteers had at least one lumbar disc degeneration in grade 3. 31 (17.4%) aviators presented lumbar disc bulging and 21 (11.8%) presented lumbar disc protrusion. 45 (25.3%) aviators reported back pain during the last 12 months. Multivariate logistic regression analysis showed age, cervical disc degeneration and bulging were risk factors for neck pain; lumbar disc degeneration, bulging and protrusion were risk factors for back pain. Conclusions: Moderate degrees of disc degenerative changes and diseases of spine could be found in new graduate aviators at an early age. Disc degeneration and diseases correlate strongly with spinal pain. It is essential to recognize these pathological conditions to intervene in the occurrence and development of degenerative changes in aviators in advance.

Download Full-text