Asymmetry between the superior and inferior endplates is a risk factor for lumbar disc degeneration

• Published in: Journal of orthopaedic research 2018-09, Vol.36 (9), p.2469-2475
• Main Authors: Wang, Yitao, Wang, Hongli, Lv, Feizhou, Ma, Xiaosheng, Xia, Xinlei, Jiang, Jianyuan
• Format: Article
• Language: English
• Subjects: endplate; endplate morphology; lumbar disc degeneration; lumbar disc herniation; magnetic resonance imaging
• ISSN: 0736-0266; 1554-527X
• DOI: 10.1002/jor.23906

ABSTRACT Endplate pathology plays an important role in the development of lumbar disc degeneration. Previous research paid little attention to differences between the superior and inferior endplates as a possible risk factor for disc degeneration. The purpose of this study was to test the hypothesis that asymmetry between the superior and inferior endplates is a risk factor for the development of lumbar disc degeneration. A total of 134 patients with lumbar disc herniation (LDH) and 100 healthy adults (“Controls”) underwent magnetic resonance imaging scans. Each disc was categorized as non‐degenerated (Pfirrmann grades I–II) or degenerated (Pfirrmann grades III–V) and get the following three groups: “Degenerated LDH” discs (n = 145), “Non‐degenerated LDH” discs (n = 525) and “Non‐degenerated Control” discs (n = 500). On mid‐sagittal image, the lumbar endplate morphology could be categorized into three types: Flat, concave, and irregular. Superior and inferior endplates of a given disc were “symmetric” if both were of the same type, and “asymmetric” if they were of different types. The proportion of asymmetric endplates at L4–5 was higher in the “Degenerated LDH” discs group (47%) than in the “Non‐degenerated LDH” discs group (21%) or “Non‐degenerated Control” discs group (7%) (p