Three-Dimensional Morphometric Analysis of Lumbar Vertebral End Plate Anatomy

Singh, Telvinderjit; Parr, William C.; Choy, Wen Jie; Budiono, Gideon Richard; Maharaj, Monish; Mathis, Xavier; Phan, Kevin; Mobbs, Ralph J.

doi:10.1016/j.wneu.2019.11.158

Cited by 7 publications

(2 citation statements)

References 28 publications

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“…Finally, computational works were excluded in this review because we specifically focused on available clinical data regarding post-operative LIF complications. There are, however, computational and 3D morphometric studies that have analysed geometric and bone density-related factors of the lumbar endplate [ 96 – 98 ]. These studies showed variations of endplate shape across lumbar levels and influence of cage positions on fusion outcomes and may be useful in informing the design of future interbody devices.…”

Section: Discussionmentioning

confidence: 99%

Influence of the geometric and material properties of lumbar endplate on lumbar interbody fusion failure: a systematic review

Robinson

Ackland

et al. 2022

J Orthop Surg Res

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Background Lumbar interbody fusion (LIF) is an established surgical intervention for patients with leg and back pain secondary to disc herniation or degeneration. Interbody fusion involves removal of the herniated or degenerated disc and insertion of interbody devices with bone grafts into the remaining cavity. Extensive research has been conducted on operative complications such as a failure of fusion or non-union of the vertebral bodies. Multiple factors including surgical, implant, and patient factors influencing the rate of complications have been identified. Patient factors include age, sex, osteoporosis, and patient anatomy. Complications can also be influenced by the interbody cage design. The geometry of the bony endplates as well as their corresponding material properties guides the design of interbody cages, which vary considerably across patients with spinal disorders. However, studies on the effects of such variations on the rate of complications are limited. Therefore, this study aimed to perform a systematic review of lumbar endplate geometry and material property factors in LIF failure. Methods Search keywords included ‘factor/cause for spinal fusion failure/cage subsidence/cage migration/non-union’, ‘lumbar’, and ‘interbody’ in electronic databases PubMed and Scopus with no limits on year of publication. Results In total, 1341 articles were reviewed, and 29 articles were deemed suitable for inclusion. Adverse events after LIF, such as cage subsidence, cage migration, and non-union, resulted in fusion failure; hence, risk factors for adverse events after LIF, notably those associated with lumbar endplate geometry and material properties, were also associated with fusion failure. Those risk factors were associated with shape, concavity, bone mineral density and stiffness of endplate, segmental disc angle, and intervertebral disc height. Conclusions This review demonstrated that decreased contact areas between the cage and endplate, thin and weak bony endplate as well as spinal diseases such as spondylolisthesis and osteoporosis are important causes of adverse events after LIF. These findings will facilitate the selection and design of LIF cages, including customised implants based on patient endplate properties.

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Section: Discussionmentioning

confidence: 99%

Influence of the geometric and material properties of lumbar endplate on lumbar interbody fusion failure: a systematic review

Robinson

Ackland

et al. 2022

J Orthop Surg Res

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“…Moreover, the lower endplates of caudal lumbar vertebrae were more concave than those in cranial lumbar vertebrae, which was in accordance with the measuring result of previous studies. [ 18 , 19 ] However, the precision of comparisons may be affected by insufficient sample sizes, unequal gender ratios, and different gauging techniques in different studies. Thus, the comparison results should be cautiously accepted, and further gender-specific studies with large sample are needed to perform to get more accurate comparisons.…”

Section: Discussionmentioning

confidence: 99%

Morphologic analysis of Chinese lumbar endplate by three-dimensional computed tomography reconstructions for helping design lumbar disc prosthesis

Pan

Zhang²,

Zhu

et al. 2021

Medicine

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Lumbar disc prostheses have been used increasingly in recent years. The successful design of lumbar disc prostheses depends on accurate morphometric parameters. However, the morphologic dimensions of lumbar endplate area have not been investigated in Chinese population. A total of 1800 lumbar endplates were retrospectively accessed in 150 Chinese adults. Eighteen parameters of each lumbar segment were measured by three-dimensional computed tomography reconstructions from T12/L1 to L5/S1. These obtained parameters were compared between genders, bilateral sides, vertebral segments, and different populations. Endplate length and width increased in general, and there was a significant decrease for length/width ratio from T12 to S1 ( P = .03). The average concavity depth of the lower lumbar endplate (2.09 ± 0.93 mm) was usually larger than that of the upper lumbar endplate (1.61 ± 0.74 mm) ( P = .02). The percentage of the most concave point of the upper and lower lumbar endplate was 50.01 ± 10.76% and 56.41 ± 9.93%, respectively. Anterior, medium, or posterior intervertebral endplate height was severally 10.01 ± 1.98 mm, 10.46 ± 2.03 mm, and 6.41 ± 1.74 mm, and increased among vertebral segments ( P = .01).The intervertebral endplate angle significantly increased from T12-L1 to L5-S1 ( P = .01). Parameters displayed significant difference between genders. The morphometric parameters of different populations also showed differences. In conclusion, there is a morphologic discrepancy in dimensions of lumbar endplate regarding genders, vertebral segments, and different populations. It is essential to design the lumbar disc prosthesis suited for Chinese patients specially, for which the morphometric parameters in our study can be utilized.

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Three-dimensional morphometric analysis of cervical vertebral endplate anatomy: A systematic literature review

Liu

Parr

Walsh

et al. 2022

Interdisciplinary Neurosurgery

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Three-Dimensional Morphometric Analysis of Lumbar Vertebral End Plate Anatomy

Cited by 7 publications

References 28 publications

Influence of the geometric and material properties of lumbar endplate on lumbar interbody fusion failure: a systematic review

Influence of the geometric and material properties of lumbar endplate on lumbar interbody fusion failure: a systematic review

Morphologic analysis of Chinese lumbar endplate by three-dimensional computed tomography reconstructions for helping design lumbar disc prosthesis

Three-dimensional morphometric analysis of cervical vertebral endplate anatomy: A systematic literature review

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