| 1.BackgroudThe vertebral endplate is the nutritious pathway of intervertebral disc and the interface of stress between disc and vertebral body. It has been reported that disc degeneration affected the morphology of the endplate, but the association between disc degeneration and the concavity of endplate which is an very important characteristic of morphology remains unknown; In recent years, it was founded that disc degeneration was frequently accompanied by MRI signal change of endplate which was closely related to low back pain; however, there are a lot of controversy about MRI signal change of endplate. Therefore, the role of endplate is becoming more and more important in disc degeneration.2. ObjectiveTo demonstrate the changes of concave angle and MRI signal of vertebral endplate in lumbar disc degeneration, and to investigate there clinical significance.3. Materials and methodsOf the 131 subjects, 29 were asymptomatic volunteers with 14 male and 15 female, the age is from 21 to 65 and average 41 years; 102 were patients with lumbar disc degeneration and without other bony or lumbar disorders, the age is from 21 to 75 and average 45 years.29 asymptomatic volunteers with 58 discs (29 L45discs and 29 L5S1 discs) were control group; According to the Tertti' s method , 102 patients with 158 degenerative discs were divided into two groups : light degeneration group with 99 discs (53 L45 discs and 46 L5S1 discs)and severe degeneration group with 59 discs(31 L45 discs and 28 L5S1 discs). Radiographs and MRI of lumbar spine were performed on every case and the images were input personal computer, the concave angle of vertebral endplate from inferior surface of L4 to superior surface of SI were measured on midsagittalT2-weighted MRI by Osiris 4. 13 image analysis software and the relative heights and sagital diameters of L4 and L5 were also measured on radiolograph by the same software.The MRI signal change of vertebral endplate were divided into type I and type IIaccording Modic' s method, the region of signal change of endplate is located according the following method: the sagital diameter and transverse diameter of endplate were divided into four parts, the center half is definited as center endplate, the other part is definited as peripheral endplate; the signal change is classified into four types according it' s region : periphery type with the change region located in periphery endplate; center type with the change region located in center endplate; extending type with the change region located in periphery endplate and extended to the center endplate; successive type with the change region located in all endplate.4. Results(l)There was no significant difference in age between control group with average 41 and degeneration group with average 45.(2)There was no significant difference between male and female in concave angle of vertebral endplate (P>0. 05) , and the concave angle of vertebral endplate decreased linearly with increasing age (L4 inferior endplate: r=-0. 46, P<0. 05; L5 superior endplate: r=-0. 64, P<0. 01; L5 inferior endplate: r=-0. 50, P<0. 01; SI superior endplate: r=-0.68, P<0. 01) .(3) The concave angle of endplate gradually increased along the control group, light degeneration group and severe degeneration group, there is significant difference in all groups (P<0. 05) but between light degeneration group and severe degeneration group in SI superior endplate (P>0.05) .(4) The relative anterior and posterior heights of vertebral body significantly decreased along control group, light degeneration group and severe degeneration group (P<0. 05) , but the relative sagital diameters significantly increased (P<0. 05) .(5) There is no MRI signal change of endplate in control group. In disc degeneration group, the signal changes of endplate were founded in 53 of 158 degenerative discs (involved 77 endplates) , type I in two discs and type II in 51 discs. There is significant difference in the incidence of signal change between light degeneration group(26.3%...
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