Characterization of bone & cartilage endplate junction in the human lumbar spine: novel ultrastructural insights & association with elemental composition, vascularity and degeneration.
Amber Salman, Muhammad Kashif Baig, Alejandro A Espinoza Orias, Ana Chee, Dino Samartzis, Uruj Zehra
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引用次数: 0
Abstract
Objective: Intervertebral disc (IVD)-related pathology is associated with integrity of cartilaginous endplate (CEP), bony endplate (BEP) and their junction. However, ultrastructural details of the CEP, BEP and IVD and their interplay with disc degenerative features such as fissures and calcification are understudied. The current study aimed to ultra structurally explore CEP-BEP junction to IVD features.
Methods: Fifty-nine lumbar motion segments from 13 male human cadavers (range, 21-80 years of age) were analyzed macroscopically, histologically and through scanning electron microscope. The fissures present in CEP & IVD and gaps at the junction of CEP-BEP & CEP-IVD were measured and correlated with calcification, vascular channels and disc degeneration. Energy-dispersive X-ray analysis (EDX) provided the elemental composition of the CEP, BEP and IVD.
Results: Ultrastructural analysis revealed gaps at the CEP-BEP junction which were occasionally bridged by fine fibrillar adhesions. These junctional gap-width were in significant positive correlation with age (p = 0.001), spinal-level (p = 0.01), severity of disc degeneration (p < 0.001) and IVD calcification (p < 0.001). The vascular channels of BEP around the CEP were in significant positive correlation with age (p = 0.003), junctional gap-width (p < 0.001) & severity of disc degeneration (p < 0.001). EDX distribution of calcium in CEP was also associated significantly with junctional gap-width & vascularity (p = 0.03, p = 0.04, respectively).
Conclusion: This is the first study to ultrastructurally assess and map lumbar CEP, BEP and IVD in humans, noting discovery of specific phenotypic patterns of intradiscal calcification, fissures, vascularity and degeneration severity as associated with novel anatomical structures of "adhesion bridges and gaps" which are implicated in marked inflammation and pain.
期刊介绍：
"European Spine Journal" is a publication founded in response to the increasing trend toward specialization in spinal surgery and spinal pathology in general. The Journal is devoted to all spine related disciplines, including functional and surgical anatomy of the spine, biomechanics and pathophysiology, diagnostic procedures, and neurology, surgery and outcomes. The aim of "European Spine Journal" is to support the further development of highly innovative spine treatments including but not restricted to surgery and to provide an integrated and balanced view of diagnostic, research and treatment procedures as well as outcomes that will enhance effective collaboration among specialists worldwide. The “European Spine Journal” also participates in education by means of videos, interactive meetings and the endorsement of educative efforts.
Official publication of EUROSPINE, The Spine Society of Europe
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