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The relation between vertebral endplate shape and lumbar disc herniations.
J Harrington1, A Sungarian, J Rogg
1Department of Neurosurgery, Brown University School of Medicine, Providence, Rhode Island, USA. J_Harrington_Jr@brown.edu
Spine
|November 8, 2001
Summary
Vertebral endplate shape is a key risk factor for developing symptomatic lumbar disc herniations. Rounder endplates increase the likelihood of posterior disc herniations, particularly at L4-L5 and L5-S1 levels.
Area of Science:
- Orthopedics
- Radiology
- Spine Surgery
Background:
- The Law of Laplace suggests anular tension relates to endplate shape and disc herniation risk.
- Lumbar disc shape and water content may allow Laplace's Law to apply.
- Endplate curvature differences may stress the anulus, increasing herniation risk.
Purpose of the Study:
- To determine if vertebral body endplate margin shape is a risk factor for symptomatic lumbar disc herniations.
- To investigate the relationship between endplate geometry and the development of disc herniations.
Main Methods:
- Blinded review of 97 contrast computed tomography scans (L4-L5, L5-S1) in patients under 60 without prior spine surgery or spondylolisthesis.
- Measurement of endplate dimensions and herniations by blinded observers.
- Calculation of endplate circularity ratio and correlation with patient factors and herniation presence.
Main Results:
- Endplate shape was strongly associated with lumbar disc herniations via logistic regression.
- Endplate area showed a less significant association, particularly in men.
Conclusions:
- Vertebral body endplate margin shape is a significant factor in the development of lumbar disc herniations.
- Endplate geometry plays a crucial role in the pathogenesis of disc herniations at L4-L5 and L5-S1.
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