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Orthopaedic Proceedings
Vol. 96-B, Issue SUPP_4 | Pages 9 - 9
1 Feb 2014
Zehra U Noel-Barker N Marshall J Adams M Dolan P
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Introduction

Disc degeneration is often scored using macroscopic and microscopic scoring systems. Although reproducible, these scores may not accurately reflect declining function in a degenerated disc. Accordingly, we compared macroscopic and microscopic degeneration scores with measurements of disc function.

Methods

Thirteen cadaveric motion segments (62–93 yrs) were compressed to 1kN while a pressure-transducer was pulled across the mid-sagittal diameter of the disc. Resulting stress profiles indicated intradiscal pressure (IDP), and maximum stress in the anterior (MaxStress_Ant) and posterior (MaxStress_Post) annulus. Macroscopic grade (1–4) of disc degeneration was based on visual examination of mid-sagittal sections, using subscales that yielded a maximum score of 48. Microscopic grade (1–4) was based on histological sections of the disc + vertebral body taken from anterior annulus, nucleus pulposus and posterior annulus, using subscale scores that totalled 108. Cartilage endplate thickness (CEP_thickness) was measured histologically, and porosity of the bony endplates was measured using micro-CT. ANOVA was used to compare between grades, and regression was used to establish dependence on scores.


Orthopaedic Proceedings
Vol. 96-B, Issue SUPP_4 | Pages 1 - 1
1 Feb 2014
Zehra U Robson-Brown K Adams M Dolan P
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Introduction

Decreasing endplate porosity has been proposed as a risk factor for intervertebral disc degeneration, because it interferes with disc metabolite transport. However, endplate porosity has recently been shown to increase with age and disc degeneration. We hypothesise that this increase reflects adaptive remodelling in response to altered loading from adjacent discs.

Methods

Nineteen cadaver motion segments (61–98 yrs) were compressed to 1kN while a pressure-transducer was pulled across the mid-sagittal diameter of the disc. Stress profiles indicated nucleus (intradiscal) pressure (IDP) and maximum stress in the anterior and posterior annulus. Subsequently, micro-CT was used to evaluate endplate porosity along the antero-posterior diameter of the adjacent endplates. Data were analysed using ANOVA and linear regression.


Orthopaedic Proceedings
Vol. 96-B, Issue SUPP_4 | Pages 2 - 2
1 Feb 2014
Matthews S Horner M Zehra U Robson-Brown K Dolan P
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Introduction

Dual energy X-ray absorptiometry (DEXA) is the gold standard for assessing bone mineral density (BMD) and fracture risk in vivo. However, it has limitations in the spine because vertebrae show marked regional variations in BMD that are difficult to detect clinically. This study investigated whether micro-CT can provide improved estimates of BMD that better predict vertebral strength.

Methods

Ten cadaveric vertebral bodies (mean age: 83.7 +/− 10.8 yrs) were scanned using lateral-projection DEXA and Micro-CT. Standardised protocols were used to determine BMD of the whole vertebral body and of anterior/posterior and superior/inferior regions. Vertebral body volume was assessed by water displacement after which specimens were compressed to failure to determine their compressive strength. Specimens were then ashed to determine their bone mineral content (BMC). Parameters were compared using ANOVA and linear regression.