INTRODUCTION: The size, shape and concavity of the lumbar vertebral endplate have been measured in vivo, suggesting a role of endplate morphometrics in disc degeneration (DD). On the other hand, endplate lesions have also been studied in relation to DD. Yet, most endplate studies are based on radiological images and findings of the associations with DD are inconsistent. The objectives of this study were to examine the relation of lumbar endplate morphometrics and lesions and DD, using cadaveric spines.
METHODS: The sample consisted of 563 vertebral endplates and 313 discs from 76 male cadaveric lumbar spines. Discography was performed to assess DD using a 4‐grade scale. The vertebrae were then dissected. The bony endplate lesions were evaluated as absent, slight to moderate, or severe, based on the size. Using a Konica laser scanner, endplates were digitalized to quantify the diameters, surface area and mean concavity depth. The circularity, which was the ratio of sagittal diameter to transverse diameter, was used to indicate the shape of the endplate. Ordered logistic regressions were used to examine the effects of endplate morphometrics and lesions on DD, adjusting for age and spinal level.
RESULTS: Lesions were found in 197 (32.8%) of endplates. Endplate lesions were associated with DD (for slight to moderate lesions OR=2.31, P<0.01; for severe lesions OR=3.54, P<0.001), adjusted for age, BMI and spinal level. Greater endplate area also was associated with more severe DD (OR=1.2, P<0.05). There were no statistically significant associations of endplate shape and concavity with DD.
DISCUSSION: The integrity of the vertebral endplate and intervertebral disc are interconnected. Endplate lesions were common and associated with discographic DD, with larger lesions associated with more severe DD. While data support an association between larger endplates and more severe adjacent DD, findings did not support a role of endplate concavity and shape in the pathogenesis of DD.