In Vitro Diffusion of DYE Through the End-Plates and the Annulus Fibrosus of Human Lumbar Inter-Vertebral Discs

Nachemson, Alf; Lewin, Thord; Maroudas, Alice; Freeman, M. A. R.

doi:10.3109/17453677008991550

Cited by 329 publications

(244 citation statements)

References 14 publications

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“…It functions both as a mechanical barrier between the pressurized NP and the vertebral bone, as well as a gateway for nutrient transport into the disc from adjacent blood vessels [9][10][11][12]. With intervertebral disc degeneration, the CEP becomes sclerotic, loses vascular contact, and exhibits decreased permeability [13][14][15][16][17][18][19]. This process is considered to contribute to disc degeneration by reducing the diffusion of nutrients to the cells of the NP [6,[20][21][22].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of intervertebral disc cartilaginous endplate structure using magnetic resonance imaging

et al. 2013

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Purpose The cartilaginous endplate (CEP) is a thin layer of hyaline cartilage positioned between the vertebral endplate and nucleus pulposus (NP) that functions both as a mechanical barrier and as a gateway for nutrient transport into the disc. Despite its critical role in disc nutrition and degeneration, the morphology of the CEP has not been well characterized. The objective of this study was to visualize and report observations of the CEP three-dimensional morphology, and quantify CEP thickness using an MRI FLASH (fast low-angle shot) pulse sequence. Methods MR imaging of ex vivo human cadaveric lumbar spine segments (N = 17) was performed in a 7T MRI scanner with sequence parameters that were selected by utilizing highresolution T1 mapping, and an analytical MRI signal model to optimize image contrast between CEP and NP. The CEP thickness at five locations along the mid-sagittal AP direction (center, 5 mm, 10 mm off-center towards anterior and posterior) was measured, and analyzed using two-way ANOVA and a post hoc Bonferonni test. For further investigation, six in vivo volunteers were imaged with a similar sequence in a 3T MRI scanner. In addition, decalcified and undecalcified histology was performed, which confirmed that the FLASH sequence successfully detected the CEP. Results CEP thickness determined by MRI in the midsagittal plane across all lumbar disc levels and locations was 0.77 ± 0.24 mm ex vivo. The CEP thickness was not different across disc levels, but was thinner toward the center of the disc. Conclusions This study demonstrates the potential of MRI FLASH imaging for structural quantification of the CEP geometry, which may be developed as a technique to evaluate changes in the CEP with disc degeneration in future applications.

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Section: Introductionmentioning

confidence: 99%

Evaluation of intervertebral disc cartilaginous endplate structure using magnetic resonance imaging

et al. 2013

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“…Maintenance of adequate levels of glucose and pH in cell culture in the laboratory can be readily achieved; however, this is not necessarily the case in the disc in situ. Indeed loss of nutrient supply leading to fall in glucose levels and accumulation of lactic acid is thought to contribute to the development of disc degeneration [74].…”

Section: Disc Nutritionmentioning

confidence: 99%

“…Together these can handle more load than each tissue alone stressing the importance of intact properly integrated structures. The cartilage endplate plays a critical role in maintaining the viability of nucleus pulposus cells [42,74]. It also prevents protrusion of the nucleus pulposus into the adjacent vertebral body.…”

Section: Introductionmentioning

confidence: 99%

Tissue engineering and the intervertebral disc: the challenges

2008

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Disc degeneration is a common disorder. Although the back pain that can develop in association with this is rarely life-threatening, the annual cost in terms of morbidity, lost productivity, medical expenses and workers' compensation benefits is significant. Surgical intervention as practised currently is directed towards removing the damaged or altered tissue. Development of new treatment modalities is critical as there is a growing consensus that the strategies used currently for symptomatic degenerative disc disease may not be effective. Accordingly, there is a need to develop an entirely new way to treat this disorder; regenerative medicine and tissue engineering approaches appear particularly promising in this regard. This paper reviews some of the challenges that currently are limiting the clinical application of this approach to the treatment of disc degeneration.

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“…In vitro studies using small dye molecules have demonstrated that the lateral margins of the endplate near the vertebral rim are relatively impermeable compared with the central portion or the entire annulus [32]. Quantitative studies with human autopsy specimens have shown that the endplate permeability is due to microscopic blood vessels in the central endplate that are more numerous than in the margins of the disc [15,28].…”

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confidence: 99%

The vertebral endplate: disc degeneration, disc regeneration

2006

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The vertebral endplates are critical for maintaining disc function yet like other components of the disc are vulnerable to degeneration. This paper provides an overview of the development and normal function of the endplates as well as an impression of what happens when they undergo progressive degeneration. Recent research suggests that the degenerative process can be retarded or reversed.Keywords Disc AE Endplate AE Degeneration AE Regeneration ManuscriptDespite all that is known from decades of research the intervertebral disc remains an enigma. It is a unique and remarkable entity and perhaps the one aspect that is responsible for much of its mystery is that such a large structure is able to survive and function under the most difficult physiological conditions. The discs of the human spine are the largest non-vascularised structures in the body, and in the largest of them (in the lumbar spine) some cells can be 20 mm from the nearest direct blood supply. Despite their apparent resilience however, the resident cells are not immortal. It is not unusual for discs to show signs of deterioration by the age of 25 years and it is in this regard that the vertebral endplate plays an important role.Discs are roughly cylindrical structures that vary in size and shape progressively from the cervical to the lumbar region. They all comprise a well-hydrated central nucleus pulposus that is surrounded by the firm but flexible collagenous lamellae of the annulus fibrosus [40]. At the cranial and caudal ends of each disc are the endplates that separate the vertebral bone from the disc itself and prevent the highly hydrated nucleus from bulging into the adjacent vertebrae. The endplates also absorb the considerable hydrostatic pressure that results from mechanical loading of the spine [10]. The endplates are typically less than 1 mm thick, and while this varies considerably across the width of any single disc, they tend to be thinnest in the central region adjacent to the nucleus [16,44].The endplates are identifiable from an early embryological stage and have an osseous as well as a hyaline cartilage component [50]. The cartilaginous component appears to generate great interest since it persists throughout normal maturation while the adjacent vertebrae undergo ossification. It comprises a gel of hydrated proteoglycan molecules reinforced by a network of collagen fibrils. Unlike the articular cartilage of the synovial joints the collagen fibrils do not connect the endplate directly to the vertebral bone [22], although the endplate does have intimate contact with the disc through the lamellae of the inner annulus [21]. A network of microscopic blood vessels penetrates the endplates during development of the growing spine, principally to provide nutrition for the disc, before disappearing around the time of skeletal maturity [50]. Apart from a sparse vascular supply in the outer

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In Vitro Diffusion of DYE Through the End-Plates and the Annulus Fibrosus of Human Lumbar Inter-Vertebral Discs

Cited by 329 publications

References 14 publications

Evaluation of intervertebral disc cartilaginous endplate structure using magnetic resonance imaging

Evaluation of intervertebral disc cartilaginous endplate structure using magnetic resonance imaging

Tissue engineering and the intervertebral disc: the challenges

The vertebral endplate: disc degeneration, disc regeneration

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