title: Dysfunctional microcirculation of the lumbar vertebral marrow prior to the bone loss and intervertebral discal degeneration.
abstract: METHODS
  Descriptive study, stratified sampling.
  
  
  OBJECTIVE
  Using dynamic computed tomographic perfusion (CTP) to explore the age-related distribution patterns of the microcirculation perfusion in the vertebral marrow, the vertebral bone mineral density (BMD), and the intervertebral discal degeneration (IDD) further to discuss the possible causation between them.
  
  
  BACKGROUND
  A latest viewpoint deemed that reduced blood supply of the vertebral marrow was correlated with an increased incidence of IDD and loss of BMD. However, the causative relationship between them needs more investigation.
  
  
  METHODS
  One hundred eighty-six general people were randomly enrolled by stratified sampling and grouped by age: 15 years or less, 16 to 25 years, 26 to 35 years, 36 to 45 years, 46 to 55 years, 56 to 65 years, 66 to 75 years, and 76 years or more. Both CTP and BMD of the third and fourth lumbar vertebral marrow were measured, and the IDD incidence of the third-fourth vertebrae was assessed. The temporal-spatial distribution patterns of the age-related changes of CTP, BMD, and IDD were described, and the correlations between them were calculated.
  
  
  RESULTS
  Microcirculatory perfusion of the vertebral marrow developed to maturate by 25 years, maintained stable at 35 years, and then declined by age after 35 years. BMD grew to a peak phase in 26 to 45 years and then dropped by years. However, IDD presented a sudden increase after 45 years of age. CTP (blood flow [r=0.806], blood volume [r=0.685], and permeability [r=0.619]) showed strong positive correlations and CTP (time to peak [r=-0.211], mean transit time [r=-0.598]) showed negative correlations with BMD. Meanwhile, CTP (blood flow [r=-0.815], blood volume [r=-0.753], and permeability [r=-0.690]) had strong negative correlations and CTP (time to peak [r=0.323] and mean transit time [r=0.628]) had positive correlations with the incidence of IDD.
  
  
  CONCLUSIONS
  Aging-related decrease of the microcirculatory perfusion of the lumbar vertebral marrow preceded the loss of BMD and the onset of IDD, indicating their possible causal relationship.
  
  
  METHODS
  3.
authors.affiliation: *Department of Medical Imaging, Southeast Hospital, Clinical School of Medical College, Xiamen University, Zhangzhou, Fujian, China; and †Department of Medical Imaging, Jinling Hospital, Clinical School of Medical College, Nanjing University, Nanjing, Jiangsu, China.
authors.forename: Lin
authors.initials: L
authors.lastname: Ou-Yang
authors.forename: Guang-ming
authors.initials: GM
authors.lastname: Lu
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000367:Age Factors; D000368:Aged; D015519:Bone Density; D001853:Bone Marrow / Q000098:blood supply* / Q000000981:diagnostic imaging; D002681:China / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D055959:Intervertebral Disc Degeneration / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D008159:Lumbar Vertebrae / Q000098:blood supply* / Q000000981:diagnostic imaging; D008297:Male; D008833:Microcirculation; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D010024:Osteoporosis / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D055420:Perfusion Imaging / Q000379:methods; D013997:Time Factors; D055815:Young Adult