The structure of the cartilaginous end-plates in elder people

Abstract

Low back pain is the leading cause of work-related disability. Degeneration of the intervertebral disc (IVD), the boundaries of which with age-related changes remain obscure, is considered to be its most important cause. The cartilaginous end-plate (CEP) is the anatomic boundary of the IVD. Since the latter is avascular in adults, the CEP is supposed to play a key role in the metabolism of the IVD. Consequently, it has been postulated that the decrease in permeability of the CEP is the main cause of degeneration of the disc. However, the permeability depends at least partially on the morphologic state of the CEP. Little is known about the age-related changes of the CEP compared to those of the IVD. The objectives of the study were to examine the CEP at different ages, to classify the age-related changes in both the CEP and IVD, and to compare them. The intervertebral discs of the five levels of ten human lumbar spines were collected from cadavers aged from 47 to 78 years, and studied macroscopically and microscopically. Morphologic features of the CEP (thickness, IVD/CEP length ratio, degree of calcification, marrow contacts, CEP-VB and CEP-IVD separations) were measured. Morphologic grades were assigned for both the CEP and the IVD. No significant differences were found with regard to these features in the different age-groups. On the other hand, no significant correlation was found between the morphologic grade of the CEP and that of the IVD, suggesting that the importance of the CEP in disc degeneration may be debatable.

Computation of coupled diffusion of oxygen, glucose and lactic acid in an intervertebral disc

“…An insufficient nutrient supply could adversely affect the ability of disc cells to synthesize and maintain the disc's extracellular matrix, threaten cells viability and lead ultimately to disc degeneration (Ishihara and Urban, 1999). The CEPs known as the major pathway for disc nutrition, undergo calcification with aging, scoliosis and degeneration (Benneker et al, 2005a, b;Bernick and Cailliet, 1982;Grignon et al, 2000;Peng et al, 2001;Roberts et al, 1993), affecting nutrient transport (Roberts et al, 1996). Here we computed how a fall in the EA arising from such calcification would influence solute concentrations in the disc.…”

A measurement technique to evaluate the macroscopic permeability of the vertebral end-plate

“…The permeability of articular cartilage is in the range of ∼1 × 10 −16 to [20][21][22]. Only a few studies focused on the cartilage end-plate [23,24] for which the permeability is of the order of ∼1.4 × 10 −15 m 4 /(N s) (baboon) [25]. Qualitative studies of mass transfer through the vertebral endplate can be obtained by diffusion of dye or small solute [1,26,27], but to our knowledge, no quantitative studies of the permeability of the vertebral end-plate has yet been published.…”

Evaluation of intervertebral disc cartilaginous endplate structure using magnetic resonance imaging

“…It functions both as a mechanical barrier between the pressurized NP and the vertebral bone, as well as a gateway for nutrient transport into the disc from adjacent blood vessels [9][10][11][12]. With intervertebral disc degeneration, the CEP becomes sclerotic, loses vascular contact, and exhibits decreased permeability [13][14][15][16][17][18][19]. This process is considered to contribute to disc degeneration by reducing the diffusion of nutrients to the cells of the NP [6,[20][21][22].…”