A pathologic study of discs in the elderly. Separation between the cartilaginous endplate and the vertebral body

Eighty-eight autopsy specimens from L4-5 lumbar discs of cadavers with an average age of 77.6 years were examined radiologically and histopathologically. They were classified into three groups by the height of intervertebral disc space: slightly degenerated (57 cases), moderately degenerated (25 cases), and severely degenerated (6 cases). Cartilaginous end-plate rupture was found most commonly in the severely degenerated group. Reverse orientation of the anulus fibrosus was found in one third of all specimens. End-plate was separated from vertebral body in 45 cases (51.1%) of 88 specimens. From the findings it is suggested that the end-plate is avulsed from the vertebral body under the precondition of separation and then herniated with anchoring anulus fibrosus. This type of herniation occurs more often than herniation of the nucleus pulposus in the elderly.