Micro-CT quantification of subchondral endplate changes in intervertebral disc degeneration.
BACKGROUND
The intervertebral disc (IVD) is dependent on nutrient provision through a cartilage layer with underlying subchondral bone, analogous to joint cartilage. In the joint, subchondral bone remodeling has been associated with osteoarthritis (OA) progression due to compromised nutrient and gas diffusion and reduced structural support of the overlaying cartilage. However, subchondral bone changes in IVD degeneration have never been quantified before.


OBJECTIVE
The aim of this study is to determine the subchondral bone changes at different stages of IVD degeneration by micro-CT.


METHODS
Twenty-seven IVDs including the adjacent vertebral endplates were obtained at autopsy. Midsagittal slices, graded according the Thompson score, were scanned. Per scan 12 standardized cylindrical volumes of interest (VOI) were selected. Six VOIs contained the bony endplate and trabeculae (endplate VOIs) and six accompanying VOIs only contained trabecular bone (vertebral VOIs). Bone volume as percentage of the total volume (BV/TV) of the VOI, trabecular thickness (TrTh) and connectivity density (CD) were determined.


RESULTS
An increase in BV/TV and TrTh was found in endplate VOIs of IVDs with higher Thompson score whereas these values remained stable or decreased in the vertebral VOIs.


CONCLUSIONS
The increase in bone volume combined with the increase in TrTh in endplate VOIs strongly suggest that the subchondral endplate condenses to a more dense structure in degenerated IVDs. This may negatively influence the diffusion and nutrition of the IVD. The endplate differences between intact and mild degenerative IVDs (grade II) indicate an early association of subchondral endplate changes with IVD degeneration.
Dept. Orthopaedics, University Medical Center Utrecht, Utrecht, The Netherlands. j.rutges@umcutrecht.nl
J P H J
JP
Rutges
O P
OP
Jagt van der
F C
FC
Oner
A J
AJ
Verbout
R J M
RJ
Castelein
J A
JA
Kummer
H
H
Weinans
L B
LB
Creemers
W J A
WJ
Dhert
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001842:Bone and Bones / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D055959:Intervertebral Disc Degeneration / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000473:pathology*; D055114:X-Ray Microtomography; D055815:Young Adult