The Research Of Cervical Inter-vertebral Disc Degeneration And Endplate Degeneration By MRI

Chronic cervical pain accounts for a large amount of patients in clinical procedures with various symptoms. Cervical spondylosis and cervical instability are of the majority in those treated with operations. With the development of the society ,division of careers and the aging problems, cervical spondylosis has tendency of increasing these years. Cervical spondylosis is a chronic degeneration of the cervical spine, it is always the consequence of cervical disc degeneration. The relationship between lumbar disc degeneration and cervical disc degeneration has been studied for years. Researchers are interested in the Modic changes of lumbar endplate while the degeneration of cervical endplate is rarely reported. So we started this research concentrating on the MRIimagination of the cervical endplate Modic change. As a noninvasive study, MRI shows us the morphology of the nuclear signal intensity and posterior annulus of the inter-vertebral disc. It has been established that MRI is very useful for the diagnosis of cervical inter-vertebral disc herniation. Endplate degeneration on MRI can be divided into three categories according to the signal change both on the T1 and T2 imagine. Diffusion from the endplate is the major approach to nutrition the disc which is avascular. Biomechanically, the endplate is vulnerable to vertical forces which can produce cartilage endplate fracture. The calcification in the fracture lesion will lead to malnutrition of the disc and result in degeneration of the intervertebral disc subsequetly. The relationship between modic change and low back pain have been brought into discussion. We studied degeneration changes of the inter-vertebral discs and endplate by evaluating the grade of disc degeneration and endplate degeneration from loss of signal intensity, disc protrusion, narrowing of the disc space and loss of signal intensity of the endplate on MRI to find the potential relationship between them.MethodsBetween January 2006 and July 2006,638 patients were considered suitable for the evaluation, including 350 male and 288 female from 11 to 86 years old, the average age is 46.72-year-old inmale and 46.59-year-old in female. We studied degeneration changes of the intervertebral discs and endplate by evaluating the grade of disc degeneration and endplate degeneration from loss of signal intensity, disc protrusion, narrowing of the disc space and loss of signal intensity of the endplate on MRI.Results1.3828 inter-vertebral discs from C2-3 to C7T1 were evaluated, wefound that grade three and four degeneration of inter-vertebraldiscs were of the predominant grade, and C5-6 were the mostsevere segment, which is the same in male and female.2. Herniation of cervical inter-vertebral disc were most likely tooccur in C5-6.3.Endplate degeneration were found 10.5% of all the patients, grade two degeneration of endplate was the most to be found in patients about 40 to 69 years old. In patients with endplate degeneration, cervical inter-vertebral disc degeneration with grade three or four were always found, meanwhile ,cervical disc herniation were likely to be found in patients with endplate degeneration.Conclusion:1. The frequency of all degenerative findings increase after 20-year-old,and the lower cervical inter-vertebral discs are likely to be involved, especially in C5-6.2. Endplate degeneration was found in 10.5% of all subjects ,in which the grade of disc degeneration is severe. Our result shows the coherence between cervical disc degeneration and cervical endplate degeneration.