1. Degeneration alters structure-function relationships at multiple length-scales and across interfaces in human intervertebral discs.
- Author
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Ashinsky BG, Gullbrand SE, Wang C, Bonnevie ED, Han L, Mauck RL, and Smith HE
- Subjects
- Aged, Aged, 80 and over, Female, Humans, Intervertebral Disc diagnostic imaging, Intervertebral Disc pathology, Intervertebral Disc Degeneration diagnostic imaging, Intervertebral Disc Degeneration pathology, Lumbar Vertebrae diagnostic imaging, Lumbar Vertebrae pathology, Male, Middle Aged, X-Ray Microtomography, Intervertebral Disc physiopathology, Intervertebral Disc Degeneration physiopathology, Lumbar Vertebrae physiopathology
- Abstract
Intervertebral disc (IVD) degeneration and associated back pain place a significant burden on the population. IVD degeneration is a progressive cascade of cellular, compositional, and structural changes, which results in a loss of disc height, disorganization of extracellular matrix architecture, tears in the annulus fibrosus which may involve herniation of the nucleus pulposus, and remodeling of the bony and cartilaginous endplates (CEP). These changes to the IVD often occur concomitantly, across the entire motion segment from the disc subcomponents to the CEP and vertebral bone, making it difficult to determine the causal initiating factor of degeneration. Furthermore, assessments of the subcomponents of the IVD have been largely qualitative, with most studies focusing on a single attribute, rather than multiple adjacent IVD substructures. The objective of this study was to perform a multiscale and multimodal analysis of human lumbar motion segments across various length scales and degrees of degeneration. We performed multiple assays on every sample and identified several correlations between structural and functional measurements of disc subcomponents. Our results demonstrate that with increasing Pfirrmann grade there is a reduction in disc height and nucleus pulposus T2 relaxation time, in addition to alterations in motion segment macromechanical function, disc matrix composition and cellular morphology. At the cartilage endplate-vertebral bone interface, substantial remodeling was observed coinciding with alterations in micromechanical properties. Finally, we report significant relationships between vertebral bone and nucleus pulposus metrics, as well as between micromechanical properties of the endplate and whole motion segment biomechanical parameters, indicating the importance of studying IVD degeneration as a whole organ., (© 2020 Anatomical Society.)
- Published
- 2021
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