The Failure Strength and Patterns of Human Degenerated Intervertebral Disc in Resisting the Hydrostatic Pressure
Date Issued
2008
Date
2008
Author(s)
Tseng, Wen-Li
Abstract
Objective： To evaluate the strength of hydrostatic pressure of endplate and the spreading pattern of contrast agent in the disc. ummary of Background Data： One of the disc degeneration therapies is to inject the biomaterials, which replace or promote regeneration of nucleus into the nucleus pulposus. To determine the efficacy of this therapy and the criteria of patient selection, it is important to evaluate the hydrostatic pressure strength of endplate and the injection pattern of contrast agent in the disc. ethods：Fifteen discs from 5 cadaver thoracic and lumbar spines (aged 77-92 years, mean age: 86 years) were injected with contrast agent using the quantitative discomanometry (QD) apparatus. The injection process was scanned with cine-CT. The endplate leakage pressure, spreading pattern of contrast agent in the disc, and the correlation between leakage pressure and bone mineral density (BMD) were analyzed. To observe the grade of endplate degeneration and the leakage site of the contrast agent, the discs were sectioned along the coronal plane, and macroscopic photographed.esult：The center region of endplate (1.03±0.14mm) was the thinner than the one of periphery region (1.26±0.06mm). Spreading patterns of contrast agent in the disc included “nucleus space expansion” and “anular fissure formation”. The contrast agent was found to leak through the endplate and the anulus fibrosis. The endplate leakage pressure (0.18±0.17MPa) was lower than the anular leakage pressure (0.27±0.21MPa). The endplate and anular leakage pressure were found positively correlated with BMD. Comparing CT images to macroscopic photographies, the contrast agent leaked through the fissure and the sclerosis site of endplate. The discontinuous lines between endplate and disc in CT images may be the indication of endplate degeneration.onclusion：Both of the endplate leakage pressure and the anular leakage pressure were correlated positively with BMD. The contrast agent spread through the anular fissure of disc, and leaked through the fissures and the sclerosis site of endplate.
Subjects
endplate
quantitative discomanometry
computed tomography
BMD
hydrostatic pressure
Type
thesis
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