Objective To explore anatomic features of adult lumber vertebral endplantes under CT imaging, and provide anatomical evidence for the design of intervertebral fusion and the complications of disc arthroplasty surgery. Methods The CT data of 62 non-spinal disorders patients with 310 lumbar vertebrae from L1 to L5 were measured at the upper endplates and lower endplates separately. The posterior endplates of lumbar vertebral at coronal plane were classified into 3 types: type I concave; type Ⅱ flat; type Ⅲ convex. The following data were measured: (1) Vertical distances from middle line of the endplate to left pedicle of the upper and lower endplates, to midpoint of the connecting endplate (LLU, LLL); (2) Vertical distances from middle line of the endplate to right pedicle of the upper and lower endplates, to midpoint the connecting endplate ( LRu, LRL) (3) Vertical distances from middle line of the endplate to the midpoint of the of the posterior upper and lower endplates at coronal plane (LMu, LML). Results Type I endplates had the highest proportion from L1~4 at the upper and lower endplates. At L1, L2, L3, L4, type I endplate accounted for 93.75%, 77.27%, 58.33%, 66.67% of upper endplate respectively, and 80%, 68.18%, 54.17%, 55.56% of lower endplate respectively. Type I and type Ⅲ were the main types of upper endplate at L5, accounting for 35.48%, 35.48%. Type Ⅲ was the main type of lower endplate at L5 , accounting for 61.29% . Sex difference of LLU、LRU、LMU of the upper endplates at L2 was statistically significant(P<0.05). Sex difference of LLL、LRL of the lower endplates at L3 was all statistically significant(P<0.05). Conclusions The mainly types of upper and lower endplates at L1~4 are type I, while the types of upper endplate at L5 are type I and type Ⅱ, the type of lower endplate at L5 is Type III. The research on morphological classification and measurement of upper and lower endplates of lumbar vertebral will be beneficial to the improvement of future design of the artificial lumbar disc prosthesis.
Key words
Lumbar vertebral /
Endplate /
Morpho-logy /
Lumbar disc replacement
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
References
[1] Taylor JR. Growth of human intervertebral discs and vertebral bodies[J]. J Anat, 1975, 120 (Pt 1): 49-68.
[2] Moore RJ. The vertebral endplate: disc degeneration, disc regeneration[J]. Eur Spine J, 2006, 15 (Suppl 3): S333-S337.
[3] Guyer RD, Auer PB, Zigler JE, et al. P1. Relationship between endplate morphology and clinical outcome of single-level lumbar disc arthroplasty[C]. Elsevier Inc, 2009: 114.
[4] Eijkelkamp MF, van Donkelaar CC, Veldhuizen AG, et al. Requirements for an artificial intervertebral disc[J]. Int J Artif Organs, 2001, 24(5): 311-321.
[5] Lakshmanan P, Dvorak V, Schratt W, et al. Is there a difference in shape of the endplates in sagittal plane? A morphometric study of the lumbosacral spine[J]. The Spine Journal, 2010, 10(9-supp-S): S46-S46.
[6] van der Houwen EB, Baron P, Veldhuizen AG, et al. Geometry of the intervertebral volume and vertebral endplates of the human spine[J]. Ann Biomed Eng, 2010, 38(1): 33-40.
[7] Clavel P, Ungureanu G, Catalá I, et al. Health-related quality of life in patients undergoing lumbar total disc replacement: a comparison with the general population[J]. Clin Neurol Neurosurg, 2017, 160:119-124.
[8] Punt IM, Visser VM, van Rhijn LW, et al. Complications and reoperations of the SB Charité lumbar disc prosthesis: experience in 75 patients[J]. Eur Spine J, 2008, 17(1): 36-43.
[9] 阮狄克. 对人工腰椎间盘置换术的几点看法[J]. 中国脊柱脊髓杂志, 2002, 12(3): 168.
[10]Galbusera F, Bellini CM, Zweig T, et al. Design concepts inlumbar total disc arthroplasty[J]. Eur Spine J, 2008, 17(12): 1635-1650.
[11]Lin CY, Kang H, Rouleau JP, et al. Stress analysis of the interface between cervical vertebrae end plates and the Bryan, Prestige LP, and ProDisc-C cervical disc prostheses: an in vivo image-based finite element study[J]. Spine (Phila Pa 1976), 2009, 34(15):1554-1560.
[12]Van Steenbrugghe MH. Improvements in joint prosthesis[P]. French Patent, 1956: 122-128.
[13]Fernstrom U. Arthroplasty with intercorporal endoprothesis in herniated disc and in painful disc[J]. Acta Chir Scand Suppl, 1966, 357: 154-159.
[14]白文媛, 顾洪生, 廖振华, 等. 正常成人腰椎间盘相关参数的测量和意义[J]. 中国临床解剖学杂志, 2013, 31(5): 505.
[15]Cheng CC, Ordway NR, Zhang X, et al. Loss of cervical endplate integrity following minimal surface preparation[J]. Spine (Phila Pa 1976), 2007, 32(17): 1852-1855.
[16] Ferguson S, Steffen T. Biomechanics of the aging spine[J]. Eur Spine J, 2003, 12(Suppl 2): S97-S103.
[17]de Beer N, Scheffer C. Reducing subsidence risk by using rapid manufactured patient-specific intervertebral disc implants[J]. Spine J, 2012, 12(11): 1060-1066.
