School of Mechanical Engineering, The Fleischman Faculty of Engineering, Tel Aviv University, Tel Aviv 69978, Israel.
Institute of Orthopaedic Research and Biomechanics, University of Ulm, Helmholtzstrasse 14, 89081 Ulm, Germany.
Spine J. 2018 Nov;18(11):2119-2127. doi: 10.1016/j.spinee.2018.06.356. Epub 2018 Jun 30.
The intervertebral disc (IVD) is a complex organ that acts as a flexible coupling between two adjacent vertebral bodies and must therefore accommodate compression, bending, and torsion. It consists of three main components, which are elegantly structured to allow this: the annulus fibrosus (AF), the nucleus pulposus (NP), and the end-plates (EP).
Thus far, it has not been possible to examine the microarchitecture of the disc directly in three dimensions in its unaltered state and thus knowledge of the overall architecture of the disc has been inferred from a range of imaging sources, or by using destructive methods.
A nondestructive ultrahigh field Magnetic Resonance Imaging (MRI) of 11.7 T was used together with image analysis to visualize the ovine IVDs.
Three-dimensional image stacks from eight IVDs harvested from sheep, half of which were 4 to 5 years old and the others approximately 2 years old were reconstructed and examined, and their microstructure were imaged. The overall structure of the disc, including the average of 14 AF lamellae (9-28), NP, and EP was then visualized with particular attention given to integrating elements as radial translamellar cross-links, AF-NP transition zone EP-AF integration and EP-NP insertion nodes (ie the connecting junctions between the EP and NP). Moreover, collagen fiber orientation was determined at different depths and locations throughout the annulus.
It was found that there was a clearer demarcation in the AF-NP transition zone of the younger discs compared with the older ones. This difference was reflected in the visibility of AF-NP and EP-AF integration. It was also possible to view the fiber architecture of the AF-NP integration in greater depth than was possible previously with histological techniques. These fibers were mainly observed in the younger discs and their length was measured to be of 2.6 ± 0.2 mm.
The present results provide a substantial advance in visualization of the three-dimensional architecture of an intact IVD and the integration of its components.
椎间盘(IVD)是一个复杂的器官,作为两个相邻椎体之间的柔性连接,因此必须适应压缩、弯曲和扭转。它由三个主要部分组成,这些部分结构精巧,允许这样做:纤维环(AF)、髓核(NP)和终板(EP)。
到目前为止,还不可能在其未改变的状态下直接以三维方式检查椎间盘的微观结构,因此对椎间盘整体结构的了解是从一系列成像源推断出来的,或者是通过使用破坏性方法。
使用无损超高场磁共振成像(MRI)11.7T 与图像分析相结合,对羊的 IVD 进行可视化。
从 8 个取自绵羊的 IVD 中重建和检查了三维图像堆栈,其中一半年龄为 4 到 5 岁,另一半年龄约为 2 岁,并对其微观结构进行了成像。然后观察椎间盘的整体结构,包括平均 14 个 AF 板(9-28 个)、NP 和 EP,并特别注意整合元素,如径向跨板交叉链接、AF-NP 过渡区 EP-AF 整合和 EP-NP 插入节点(即 EP 和 NP 之间的连接结)。此外,还确定了在整个环的不同深度和位置的胶原纤维方向。
发现年轻椎间盘的 AF-NP 过渡区比老年椎间盘的分界更清晰。这种差异反映在 AF-NP 和 EP-AF 整合的可见性上。与以前的组织学技术相比,还可以更深入地观察 AF-NP 整合的纤维结构。这些纤维主要在年轻的椎间盘观察到,其长度测量为 2.6±0.2mm。
本研究结果在可视化完整 IVD 的三维结构及其组件的整合方面取得了重大进展。