Sagittal endplate morphology of the lower lumbar spine

Lakshmanan, Palaniappan; Purushothaman, Balaji; Dvorak, Vlasta; Schratt, Walter; Thambiraj, Sathya; Boszczyk, Bronek M.

doi:10.1007/s00586-012-2168-4

Cited by 33 publications

(18 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…* One-way ANOVA among endplates ** Paired samples student t test between superior and inferior endplate of each vertebra studies, the surface shape of endplate is not totally flat, but rather approximates an arch, with the central area somewhat depressed [15][16][17]. However, in contrast to the morphological complexity of vertebral endplates, the endplate designs of anterior cervical fusion devices are significantly simplified, i.e, the sagittal profile of most currently available anterior cervical fusion constructs is limited to flat endplate or at the best minor convexity with some modularity of the slope angle.…”

Section: Discussionmentioning

confidence: 99%

Sagittal geometry of the middle and lower cervical endplates

et al. 2013

View full text Add to dashboard Cite

Purpose Construct subsidence is a relatively common complication following anterior cervical fusion. Its occurrence has been revealed to be closely related to endplateimplant contact interface. But current literature focusing on the anatomy of cervical endplate is very scarce. The purpose of this morphometric study was to analyse the sagittal geometry, especially the concavity and slope, of vertebral endplates from C3 to C7 by employing data from CT scans. Methods Reformatted CT scans of 97 individuals were analyzed and endplate concavity depth, endplate concavity apex location, as well as endplate slope were measured in midsagittal plane. Those specific parameters were compared among different age and gender groups. Meanwhile, comparison between superior and inferior endplate of each vertebra was also performed. Results Age and gender did not influence endplate concavity depth, endplate concavity apex location, or endplate slope significantly (P [ 0.05). Endplate concavity depths of superior endplates (range 0.9-1.2 mm) were significantly smaller than those of inferior endplates (range 2.1-2.7 mm). Endplate concavity apex was always located in the posterior half of the endplate, with the superior one ranged from 56 to 67 % and the inferior one 52 to 57 %. Average endplate slopes of superior endplates were between 4.5°and 9.0°, and average inferior endplate slopes ranged from 4.5°to 7.5°. Among all measured segments, C5 had the largest endplate slope values, while C7 the least. Conclusions Superior endplate is more flat than its inferior counterpart in middle and lower cervical spine, and the concavity apex is always located in the posterior half of the endplate. Endplate slope is correlated with cervical curvature, greater slope implying more significant lordosis. These sagittal endplate geometrical parameters should be taken into consideration when investigating implant subsidence following anterior cervical fusion.

show abstract

Section: Discussionmentioning

confidence: 99%

Sagittal geometry of the middle and lower cervical endplates

et al. 2013

View full text Add to dashboard Cite

show abstract

“…Since the main and most important pathway for diffusion into the NP occurs from capillaries in the vertebral body via diffusion through the cartilaginous endplate 56 , another limitation is the lack of evaluation of vertebral endplate morphology. As described by Lakshmanan et al 57 , concavity of the lumbar endplates is symmetrical in the frontal plane but shape shows considerable variability in the sagittal plane (flat, oblong or ex-centric), with inferior endplate shape becoming more ex-centric, i.e. location of the concavity apex in the posterior half of endplate (54-60% endplate diameter), from L 3 to L 5 levels.…”

Section: Discussionmentioning

confidence: 84%

The effect of the spinal mobilization in subjects with acute low back pain

Reumont¹,

Dierick²,

Thiry³

2015

http://isrctn.com/

View full text Add to dashboard Cite

Pain perception, trunk mobility in flexion, extension, and lateral flexion, and apparent diffusion coefficient (ADC) within nucleus pulposus of all lumbar discs were collected before and after posterior-to-anterior mobilization in 16 adults with acute low back pain. ADC was computed from diffusion maps and 3 specific portions of the nucleus pulposus were investigated: anterior (ADC ant ), middle (ADC mid ), and posterior (ADC post ), and their mean as ADC all , a summary measure of ADC within nucleus pulposus. Pain ratings were significantly reduced after mobilization, and mobility of the trunk was significantly increased. Concomitantly, a significant increase in ADC all values was observed. The greatest ADC all changes were observed at the L 3 -L 4 and L 4 -L 5 levels and were mainly explained by changes in ADC ant and ADC post . The simultaneous reduction in pain and increase of water diffusion within nucleus pulposus has has been previously observed in subjects with chronic conditions and exists in the acute phase of the disease. Since the largest changes in ADC were observed at the periphery of the nucleus pulposus, and taken together with pain decrease, our results suggest that increased peripheral random motion of water molecules is implicated in the modulation of the intervertebral disc nociceptive response. Methods SubjectsA priori estimation of the sample size was carried out by using G*Power software (Version 3.1.9.2), with an α level (I) equal to 0.05 and β level (II) equal to 0.20, with a statistical power of 0.80. The estimation was made on the basis of the average results obtained by Beattie et al. 10 which have shown a significant increase of the ADC at the L 1 -L 2 IVD (1.70±0.25 × 10 −3 mm 2 s −1 versus 1.80±0.24 × 10 −3 mm 2 s −1 ) after lumbar PA mobilization in young subjects with LBP with a low pain intensity. An effect size dz of 0.41 was calculated for unilateral t test for paired samples and a correlation between the groups of 0.5. The estimate of the total size of the sample data is 39 that means 20 subjects suffering from acute LBP, as each subject provides two data.This study was conducted on a sample of 16 adult patients (11 women and 5 men) suffering from acute idiopathic LBP diagnosed by a physician, that were consecutively recruited from a private physical therapy practice (OMT Skills, La Louvière, Belgium); age: 46±16 years (range: 26-85), height: 165.8±9 cm, weight: 73.4±17 kg, and body mass index: 26.6±4 kg m −2 . The inclusion and exclusion criteria of the subjects were similar to previous studies 16,17 . Inclusion criteria were: be aged between 20 to 85 years, suffering from acute LBP (< 6 weeks of pain), having 1 month without pain between the current and previous episodes of LBP, subject must have had more days without pain than days with pain in the past year. Exclusion criteria include: aversion to spinal manipulation, chronic LBP, radiating pain below the knees, spine fracture or surgery, osteoporosis, pregnancy, implanted devices that could interact with the magnetic fiel...

show abstract

“…Although previous anthropological studies report linear dimensions for the vertebrae using cadaveric specimens, the present study is the first to measure in vivo 3D surface area of the bony endplates in humans along the entire spine. In this work, we formulated a linear relationship by introducing a new quantitative position parameter, which may be useful for quantitative studies in anthropology and comparative medicine.…”

Section: Discussionmentioning

confidence: 99%

“…Measurement of the endplate surface area provides essential information to be used for estimation of stress and pressure in intervertebral discs, estimation of disc volume and adequate sizing of spinal implants. To date, these endplate morphological parameters have been gathered mainly by means of planar methods . Since the endplate actually has complex three‐dimensional (3D) geometry, questions arise about whether appropriate 3D endplate surface models are necessary for accurate measurements of any morphological parameter, including the surface area.…”

mentioning

confidence: 99%

“…To date, these endplate morphological parameters have been gathered mainly by means of planar methods. [6][7][8][9][10][11][12][13] Since the endplate actually has complex three-dimensional (3D) geometry, questions arise about whether appropriate 3D endplate surface models are necessary for accurate measurements of any morphological parameter, including the surface area. Information on the endplate surface area spanning the entire human spine is limited in the literature.…”

mentioning

confidence: 99%

See 1 more Smart Citation

In vivo measurement of vertebral endplate surface area along the whole‐spine

Kishimoto

Akeda

Sudo

et al. 2016

Journal Orthopaedic Research

View full text Add to dashboard Cite

Accurate determination of vertebral endplate surface area and diameters plays an important role in surgical procedures, spinal implant design and sizing. The objective of this study was to contribute with baseline information on the endplate geometrical parameters using subject-based 3D whole-spine computed tomography (CT) models based on myelogram CT images taken of 49 patients with spinal disorders. Superior and inferior bony endplate mesh-models were created from said 3D CT models and endplate geometrical parameters including total polygon-mesh areas, projected areas and antero posterior and transverse diameters of each endplate were measured. The position of each endplate was determined by the cumulative distance along the spinal column with respect to C2. Endplate area and diameters were analyzed by gender, spinal level, age and correlation with spinal position. Males had larger endplates than females at all levels (p < 0.05) but S1. While endplate areas and transverse diameters increased with age at C3-L5 in females, these increases were not consistent through the whole-spine and even decreases with age were found at T1-T3 in males. There was a strong linear correlation between endplate area and spinal position in males and females with correlation coefficient values of r ¼ 0.938 and r ¼ 0.911, respectively. However, multiple comparisons of the geometrical parameters through the whole-spine revealed localized reduction of the anteroposterior or transverse diameters at T4 and L5-S1 levels. These regional and agerelated changes in endplate dimensions should be taken into account for safe interventional treatments at these sites. Keywords: endplate; surface area; endplate dimension, spine; computed tomography; three-dimensional measurement Accurate knowledge of vertebral endplate morphology is important to better understand its structurefunction relationships, 1-4 with respect to its influence and role in intervertebral disc degeneration, and to design proper surgical procedures, tissue-engineered disc replacement constructs and spinal implants. 5,6 Measurement of the endplate surface area provides essential information to be used for estimation of stress and pressure in intervertebral discs, estimation of disc volume and adequate sizing of spinal implants. To date, these endplate morphological parameters have been gathered mainly by means of planar methods. [6][7][8][9][10][11][12][13] Since the endplate actually has complex three-dimensional (3D) geometry, questions arise about whether appropriate 3D endplate surface models are necessary for accurate measurements of any morphological parameter, including the surface area. Information on the endplate surface area spanning the entire human spine is limited in the literature. To the best of the authors' knowledge, currently there is no in vivo study providing results of 3D-based endplate surface area measurements.Continuous increases in endplate dimensions along the spine have been reported in the literature. 6,7,14,15 We hypothesize that the endplat...

show abstract

Sagittal endplate morphology of the lower lumbar spine

Cited by 33 publications

References 8 publications

Sagittal geometry of the middle and lower cervical endplates

Sagittal geometry of the middle and lower cervical endplates

The effect of the spinal mobilization in subjects with acute low back pain

In vivo measurement of vertebral endplate surface area along the whole‐spine

Contact Info

Product

Resources

About