The biology behind the human intervertebral disc and its endplates

Tomaszewski, Krzysztof A.; Saganiak, Karolina; Gładysz, Tomasz; Walocha, Jerzy

doi:10.5603/fm.2015.0026

Cited by 49 publications

(45 citation statements)

References 92 publications

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“…The slow poroelastic behavior is mediated by fluid flow, due to the binding and releasing of water by the proteoglycans in the nucleus 19) . The bound water in the nucleus generates an intradiscal osmotic pressure, which separates the vertebrae and tensions the annulus fibrosus 1 2 3 5 11 26 27) .…”

Section: Discussionmentioning

confidence: 99%

Quantitative Pfirrmann Disc Degeneration Grading System to Overcome the Limitation of Pfirrmann Disc Degeneration Grade

Rim¹

2016

Korean J Spine

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ObjectivePfirrmann disc degeneration grade is one of morphologic disc degeneration grading system and it was reliable on routine T2-weighted magnetic resonance (MR) images. The purpose of this study was to evaluate the agreement of Pfirrmann disc degeneration grade, and check the alternative technique of disc degeneration grading system.MethodsFifteen volunteers (4 medical doctors related to spinal disease, 2 medical doctors not related to spinal disease, 6 nurses in spinal hospital, and 3 para-medicines) were included in this study. Three different digitalized MR images were provided all volunteers, and they checked Pfirrmann disc degeneration grade of each disc levels after careful listening to explanation. Indeed, all volunteers checked the signal intensity of disc degeneration at the points of nucleus pulposus (NP), disc membrane, ligaments, fat, and air to modify the quantitative Pfirrmann disc degeneration grade.ResultsTotal 225 grade results of Pfirrmann disc degeneration grade and 405 signal intensity results of quantitative Pfirrmann disc degeneration grade were analyzed. Average interobserver agreement was "moderate (mean±standard deviation, 0.575±0.251)" from poor to excellent. Completely agreed levels of Pfirrmann disc degeneration grade were only 4 levels (26.67%), and the disagreement levels were observed in 11 levels; two different grades in 8 levels (53.33%) and three different grades in 3 levels (20%). Quantitative Pfirrmann disc degeneration showed relatively cluster distribution with the interobserver deviations of 0.41-1.56 at the ratio of NP and disc membrane, and it showed relatively good cluster and distribution indicating that the proposed grading system has good discrimination ability.ConclusionPfirrmann disc degeneration grade showed the limitation of different interobserver results, but this limitation could be overcome by using quantitative techniques of MR signal intensity. Further evaluation is needed to access its advantage and reliabilities.

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Section: Discussionmentioning

confidence: 99%

Quantitative Pfirrmann Disc Degeneration Grading System to Overcome the Limitation of Pfirrmann Disc Degeneration Grade

Rim¹

2016

Korean J Spine

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“…In the past few years, clinical debates and accumulating arguments have stressed the importance of the CEP and NP in the treatment of IVD degeneration. [ 12 – 14 ] A recent study has been conducted into the various modeling of lumbar IVD mechanics under different physical conditions, in order to better elucidate the functions of the native disc tissues under various loading conditions. [ 15 – 17 ] However, insufficient literature is available emphasizing the use of modeling to explore the behavior of NP replacement.…”

Section: Introductionmentioning

confidence: 99%

The influence of artificial nucleus pulposus replacement on stress distribution in the cartilaginous endplate in a 3-dimensional finite element model of the lumbar intervertebral disc

Wang

2017

Medicine

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Objective:This study aimed to investigate the effects involved with the artificial nucleus pulposus (NP) replacement on stress distribution of the cartilaginous endplate (CEP) in a 3-dimensional lumbar intervertebral disc (IVD) model using a finite element (FE) analysis.Methods:A healthy male volunteer was recruited for the purposes of the study and a spiral computed tomography scan was subsequently conducted to obtain the data information in relation to the L4/5 motion segment. An FE model of the L4/5 motion segment constructed, on the basis of which degenerative IVD, IVD with NP removal, and IVD with NP replacement were in turn built. The stress distribution of the CEP and bulging of IVD were estimated using various motion states, including axial loading, forward flexion, backward extension, left axial rotation, and right axial rotation.Results:Under different motion states, the vertebral stress was higher in the degenerative IVD, the IVD with NP removal, and the IVD with NP replacement, in comparison to that of the normal IVD. Furthermore, a higher vertebral stress was detected in the degenerative IVD than the IVD with NP removal and the IVD with NP replacement. An even distribution of vertebral stress was observed in the IVD model with an artificial NP replacement, while the vertebral stress and bulging displacement were lower than after NP removal. Our findings provided confirmation that stress of the CEP was consistent with the vertebral stress.Conclusion:This study provided evidence suggesting that NP replacement, vertebral stress, and bulging displacement are lower than that of degenerative IVD and IVD with NP removal under different motion states.

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“…The youngest specimen in our study came from a 19-year-old person. This prevented us from analyzing how cell density and GAG content change during the years (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16) when the IVD and the endplates undergo the greatest changes.…”

Section: Glycosaminoglycans In the Intervertebral Discs And The Endplmentioning

confidence: 99%

“…With ageing the IVD undergoes changes, in terms of its extracellular matrix composition, as well as cell density and character [4,5,6]. From early childhood, the blood supply to the IVD and the endplates decreases [7], together with cell density [8], leading to an increased incidence of structural defects.…”

Section: Introductionmentioning

confidence: 99%

Age- and degeneration-related variations in cell density and glycosaminoglycan content in the human cervical intervertebral disc and its endplates

Tomaszewski¹,

Walocha²,

Mizia³

et al. 2015

pjp

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The first aim of this study was to quantify cell density in cervical intervertebral discs (IVDs) and endplates of varying age and degeneration grade. The second aim was to analyze glycosaminoglycan (GAG) content in cervical IVDs and their endplates. Sixty cervical IVDs were excised from 30 human cadavers, not later than 24 hours post-mortem. Each sample underwent sectioning. Half of each sample underwent GAG content analysis using the dimethylmethylene blue binding assay. The other half underwent histological processing, histological degeneration grading, and cell density assessment using the Abercrombie method. The nucleus pulposus (NP) (4218 ±417 cells/mm 3 ) had significantly higher cell density than the anterior annulus fibrosus (AF) (3283 ±438 cells/mm 3 ; p < 0.0001), and similar cell density (4464 ±551 cells/mm 3 ; p = 0.36) to the posterior AF. Cell density was similar throughout the different regions of the endplate. The NP (619 ±178 µg/mg dry weight) had a significantly higher GAG content than both the anterior (428 ±199 µg/mg dry weight; p < 0.0001) and posterior AF (524 ±218 µg/mg dry weight; p < 0.0001). In conclusion, this study introduces detailed 3D maps of cervical IVD and endplate cell density and GAG content. Furthermore, it shows that cervical IVDs and their endplates only slightly differ, in terms of cell density and GAG content, from lumbar IVDs.

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The biology behind the human intervertebral disc and its endplates

Abstract: The intervertebral discs (IVDs) (Folia Morphol 2015; 74, 2: 157-168)

Cited by 49 publications

References 92 publications

Quantitative Pfirrmann Disc Degeneration Grading System to Overcome the Limitation of Pfirrmann Disc Degeneration Grade

Quantitative Pfirrmann Disc Degeneration Grading System to Overcome the Limitation of Pfirrmann Disc Degeneration Grade

The influence of artificial nucleus pulposus replacement on stress distribution in the cartilaginous endplate in a 3-dimensional finite element model of the lumbar intervertebral disc

Age- and degeneration-related variations in cell density and glycosaminoglycan content in the human cervical intervertebral disc and its endplates

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