A morphometric study of the middle and lower cervical vertebral endplates and their components

Abstract

Cervical disc arthroplasty is a common method of treating cervical degenerative disease. However, the footprints of most prosthesis dimensions are obtained from data of Caucasian individuals. Besides, there is a large discrepancy between footprints of currently available cervical disc prostheses and anatomic dimensions of cervical endplates. We aimed to detail the three-dimensional (3D) anatomic morphology of the subaxial cervical vertebral endplate, utilizing high-precision, high-resolution scanning equipment, and provide a theoretical basis for designing appropriate disc prostheses for Chinese patients.A total of 138 cervical vertebral endplates were studied. Each endplate was digitized using a non-contact optical 3D range scanning system and then reconstructed to quantify diameters and surface area for the whole endplate and its components (central endplate and epiphyseal rim). The whole endplate and mid-plane concavity depth were measured.There is marked morphologic asymmetry, in that the cranial endplate is more concave than the corresponding caudal endplate, with endplate concavity depths of 2.04 and 0.69 mm, respectively. For the caudal endplates, the endplate concavity apex locations were always located in the posterior portion (81.42%), while in cranial endplates relatively even. The central endplate was approximately 60% of the area of the whole endplate and the anterior section of the ring was the widest. From C3/4 down to C6/7 discs, the vertebral endplate gradually became more elliptical. Chinese cervical endplate anatomic sizes are generally smaller than that of Caucasians. Although Korean and Chinese individuals both belong to the Asian population subgroup, the majority of anatomic dimensions differ. Singaporean cervical endplate morphology is very similar to that of Chinese patients.We performed a comprehensive and accurate quantitative description of the cervical endplate, which provide references to shape and profile an artificial cervical disc without sacrificing valuable bone stock. To design a device with footprint as large as possible to distribute the axial load, we suggest that additional attention should be paid to the marginal rim. It is essential to specifically design appropriate disc prosthesis for Chinese patients. To fit the morphologic and biomechanical variations, we also propose that the disc prostheses for different vertebral segments should be separately designed.Abbreviations: 3D = three-dimensional, APD = the anteroposterior diameter, ECD = the whole endplate concavity depth, ECL = the endplate concavity apex location, SCD = the mid-sagittal plane concavity depth, SCL = the sagittal concavity apex, TD = the transverse diameter.

Reliability and reproducibility of measurements in para-sagittal planes on sub-axial cervical vertebral bodies: a morphometric study of endplates in three-dimensional models

“…4 ). The values measured on mid-sagittal planes and trends were consistent with the other studies of the measurement of the sub-axial cervical vertebra [ 1 , 4 , 7 ]. There were no significant differences between the values measured by the two observers and observer one (O1).…”

“…Morphometric studies of sub-axial cervical endplates have increased over the past decades [ 1 ], and the main purpose is to provide anatomic data for the design or optimization of the intervertebral instrument and preoperative planning. Dimensional measurements of the endplates have been carried out over a series of entities, from cadaveric vertebrae and radiographic images in the early days of implementing this approach [ 2 , 3 ] and have progressed to include technically advanced methods such as CT and MRI in recent years [ 4 , 5 ].…”

Construction of a new cervical anatomically adaptive titanium mesh cage based on measurements of cervical geometry: A morphological and cadaveric study

“…Various morphological studies, as well as the present study, have revealed that the cervical endplate is not simply flat (10,(19)(20)(21); rather, most IEPs are arched (10,21). Although most SEPs are considered relatively flat, they still exhibit a concave depth of 0.39-0.69 mm (19,20).…”

“…Various morphological studies, as well as the present study, have revealed that the cervical endplate is not simply flat ( 10 , 19-21 ); rather, most IEPs are arched ( 10 , 21 ). Although most SEPs are considered relatively flat, they still exhibit a concave depth of 0.39-0.69 mm ( 19 , 20 ). Therefore, the flat end of conventional TMCs do not match well with the endplate, leading to a very small contact area and high stress concentration at the TEI ( 4 , 7 , 10 ).…”

Morphometric analysis of typical cervical vertebral pedicle - An osteological study

“…One of the superior approaches of arthrodesis is Trans-pedicular screw. There is a need for detailed anatomical knowledge in the Indian population as the instrumentation involves damage to various vital structures, and also there is a variability in vertebral dimensions amongst different races [12][13][14][15][16][17][18][19] thus causing difficulty in the standardization of measurements. The characteristic of a typical cervical vertebrae is the presence of transversely elongated bodies.…”