title: Interference in the endplate nutritional pathway causes intervertebral disc degeneration in an immature porcine model.
abstract: OBJECTIVE
  Previous studies have shown that blocking the endplate nutritional pathway with bone cement did not result in obvious intervertebral disc degeneration (IDD) in mature animal models. However, there are very few comparable studies in immature animal models. As vertebroplasty currently is beginning to be applied in young, even biologically immature patients, it is important to investigate the effect of cement blocking at the endplate in an immature animal model.
  
  
  METHODS
  Two lumbar intervertebral discs in eight immature pigs were either blocked by cement in both endplate pathways or stabbed with a scalpel in the annulus fibrosus (AF) as a positive control, and with a third disc remaining intact as a normal control. Magnetic resonance imaging (MRI) and histology study were performed.
  
  
  RESULTS
  After three months, the cement-blocked discs exhibited severe IDD, with the percentage of disc-height index (DHI), nucleus pulposus (NP) area, and NP T2 value significantly lower than the normal control. These IDD changes were histologically confirmed. Post-contrast MRI showed diseased nutritional diffusion patterns in the cement-blocked discs. Moreover, the degenerative changes of the cement-blocked discs exceeded those of the injured AF positive controls.
  
  
  CONCLUSIONS
  The endplate nutritional pathway was interfered with and diseased after three months of bone cement intervention in an immature porcine model. Severe interference in the endplate nutritional pathway in an immature porcine model caused IDD. These findings also draw attention to the fact that interference in endplate nutritional pathways in immature or young patients may affect the vitality of adjacent discs.
authors.affiliation: Orthopaedic Research Laboratory, Aarhus University, Building 1A, Noerrebrogade 44, 8000, Aarhus C, Denmark, kang.ran@ki.au.dk.
authors.forename: Ran
authors.initials: R
authors.lastname: Kang
authors.forename: Haisheng
authors.initials: H
authors.lastname: Li
authors.forename: Steffen
authors.initials: S
authors.lastname: Ringgaard
authors.forename: Kresten
authors.initials: K
authors.lastname: Rickers
authors.forename: Haolin
authors.initials: H
authors.lastname: Sun
authors.forename: Muwan
authors.initials: M
authors.lastname: Chen
authors.forename: Lin
authors.initials: L
authors.lastname: Xie
authors.forename: Cody
authors.initials: C
authors.lastname: Bünger
mesh_terms: D000367:Age Factors; D000818:Animals; D001843:Bone Cements; D004195:Disease Models, Animal; D005260:Female; D007403:Intervertebral Disc / Q000254:growth & development / Q000502:physiology*; D055959:Intervertebral Disc Degeneration / Q000209:etiology*; D023421:Models, Animal; D009747:Nutritional Physiological Phenomena; D013552:Swine
chemical_list: D001843:Bone Cements