CHANGES IN THE INTERVERTEBRAL DISK MEDITALS URNAL5matrix, which is flexible enough to allow the fibrils to show their elasticity due to changes in orientation. The experiments undertaken show that with advancing age, beginning at the end of the third decade, there are changes in the collagen structure of both nucleus pulposus and annulus fibrosus which affect both factors.The nucleus loses its gel properties, as seen by the increased orientation and crystallization of the collagen with advancing age, whilst the collagen of annulus fibrosus undergoes similar changes, the fibrils being laid down in a uniaxial arrangement which inhibits its elastic mechanism. In these circumstances the intervertebral disk loses its normal physiological function, with secondary effects upon its asso, ciated spinal joints, particularly impaired mobility.
SunmnaryThe collagenous changes in the human intervertebral disks with age have been studied, using x-ray crystallographic methods.The x-ray diffraction diagrams so obtained prove that the elasticity of the annulus fibrosus is dependent upon the orientation and mobility of the collagen fibrils, properties which decrease with advancing age after the third decade.The x-ray diffraction diagrams of the nucleus pulposus show that increased orientation and ultimate crystallization of the collagen occurs with advancing age, indicating loss of gel structure and hence impaired elasticity.The combination of these factors will explain the reduced elasticity of the intervertebral disk with age. In a follow-up examination of adult cases of coeliac disease the serum antithrombin content estimation was used as a screening test to exclude fibrocystic disease of the p4ncreas as a possible alternative diagnosis. The results were normal in all cases but one-that of a woman three months gravid. Sera from six other pregnant women were then examined, and since in each case the antithrombin content was found to be much lower than that of normal serum the investigation now reported was undertaken. Sera were obtained from 120 women whose pregnancy varied from four weeks to full term; from 41 women whose delivery had been from one to twelve weeks previously; from cord blood at 30 births; and from 15 babies aged 1 to 14 days. All pregnancies were normal and the sera were obtained from routine laboratory collections. The babies from whom blood was obtained were likewise normal and full-term. The Results In the assessment of the results obtained the percentages of the normal of the 20-minute sample of the thrombinserum mixtufe only are considered, for in this sample any deviation from the normal is most marked. We have used the same technique over a period of more than two years: the variation in clotting time of some 800 " normal" sera in this 20-minute sample was from 90 to 110% of the mean of each batch of normals tested, and we have come to regard any figure of less than 80% as being pathological. The Chart shows the scatter of the results obtained on examination of the 120 sera taken during pregnancy and of...