Roberts S, McCall I W, Menage J, Haddaway M J, Eisenstein S M
Centre for Spinal Studies, Robert Jones and Agnes Hunt Orthopaedic and District Hospital, Oswestry, Shropshire, UK.
Eur Spine J. 1997;6(6):385-9. doi: 10.1007/BF01834064.
Degeneration of the intervertebral disc, seen radiologically as loss of disc height, is often associated with apparent remodelling in the adjacent vertebral body. In contrast, maintenance or apparent increase in disc height is a common finding in osteoporosis, suggesting the properties of the intervertebral disc may be dependent on those of the vertebral body or vice versa. We have investigated this relationship by measuring the radiological thickness of the subchondral bone and comparing it to the chemical composition of the adjacent disc. Sagittal slabs were sampled from lumbar spines obtained at autopsy and X-rayed microfocally. The thickness of the subchondral bone was measured and correlated with the composition of the adjacent intervertebral disc. Eighty-three cadaveric endplates were studied from individuals aged 17-85 years. There was regional variation in thickness of the subchondral bone, being greater adjacent to the annulus than the nucleus, and the endplates cranial to the disc were thicker than those caudal. There was a positive correlation between the thickness of the subchondral bone and the proteoglycan content of the adjacent disc, particularly in the region of the nucleus. A weaker correlation was seen here between water content and thickness, whilst there was no significant correlation at the annulus or between the bone thickness and collagen content. The positive relationship between the radiographic thickness of vertebral subchondral bone and the proteoglycan content of the adjacent disc seen in human cadaveric material could be due to the bone responding to a greater hydrostatic pressure being exerted by discs with higher proteoglycan content than by those with less proteoglycan present. It is suggested that while this is true in "normal" specimens, the relationship becomes altered in disease states, possibly because of changes to the nutritional pathway of the disc, with resultant endplate-bone remodelling affecting the flow of solutes to and from the intervertebral disc.
椎间盘退变在影像学上表现为椎间盘高度降低，常伴有相邻椎体的明显重塑。相比之下，椎间盘高度保持或明显增加是骨质疏松症的常见表现，这表明椎间盘的特性可能取决于椎体的特性，反之亦然。我们通过测量软骨下骨的放射学厚度并将其与相邻椎间盘的化学成分进行比较，对这种关系进行了研究。从尸检获得的腰椎中取样矢状切片，并进行微焦点X射线摄影。测量软骨下骨的厚度，并将其与相邻椎间盘的成分相关联。研究了83个年龄在17 - 85岁个体的尸体终板。软骨下骨厚度存在区域差异，在靠近纤维环处比髓核处更大，且椎间盘上方的终板比下方的更厚。软骨下骨厚度与相邻椎间盘的蛋白聚糖含量之间存在正相关，尤其是在髓核区域。此处水分含量与厚度之间的相关性较弱，而在纤维环处或骨厚度与胶原蛋白含量之间没有显著相关性。在人体尸体材料中观察到的椎体软骨下骨的放射学厚度与相邻椎间盘的蛋白聚糖含量之间的正相关关系，可能是由于骨对蛋白聚糖含量较高的椎间盘施加的更大静水压力做出反应，而不是对蛋白聚糖含量较低的椎间盘做出反应。有人认为，虽然在“正常”标本中情况确实如此，但在疾病状态下这种关系会发生改变，可能是因为椎间盘营养途径的变化，导致终板 - 骨重塑影响溶质进出椎间盘的流动。
