Correlation Analysis Of Osteoporosis With Lumbar Disc Degeneration And Cartilage Endplate Morphology

Background:Osteoporosis is a systemic metabolic disease that can cause severe bone loss and affect bone microstructure,leading to brittle fractures and other diseases.It is particularly common in the aging society and affects the life quality of the elderly seriously.The lumbar vertebra,endplate,and intervertebral disc are closely related,changes in the physiological function of which one directly or indirectly affect the other two.In patients with osteoporosis,the bone density of the lumbar vertebral body decreases and the microstructure of the vertebral body is destroyed,while the nutrition supply of the intervertebral disc is mainly provided by the upper and lower vertebral bodies through the endplate.Moreover,the degree of osteoporosis and the degeneration of the lumbar intervertebral disc are positively correlated with age,which is worth paying attention to.At present,some studies at home and abroad have shown that osteoporosis can promote the degeneration of intervertebral disc and lead to the change of endplate structure.However,the opposite conclusion has also been reached,that the decrease of bone density after osteoporosis is conducive to the growth of microvessels into the endplate,and osteoporosis leads to the increase of endplate space and the easier diffusion of nutrients from the vertebral body to the intervertebral disc,thereby slowing the degeneration of the intervertebral disc in patients with osteoporosis.Therefore,to clarify the correlation between vertebral body osteoporosis and endplate and lumbar intervertebral disc degeneration is of guiding significance to prevent and treat intervertebral disc degeneration in patients with osteoporosis clinically.Objective:To investigate the relationship between osteoporosis and lumbar intervertebral disc degeneration and vertebral body morphology,provide evidence for the occurrence of lumbar degenerative disease in patients with osteoporosis,provide clinical basis for clinical diagnosis and prognosis prediction,and provide early intervention treatment to delay the development of the disease.Methods:A retrospective analysis of women outpatients in Qilu hospital with spine surgery(2015.6-2018.6).According to the bone mineral density,patients are divided into 3 groups:sham,osteopenia,and osteoporosis.According to the rating pfirrmann grading of intervertebral disc and statistical end plate shape,common statistical data are collected,including height,age,weight and lumbar MRI.Statistical analysis was performed on the collected data.Results:Finally,42 patients with sham,36 patients with osteopenia,and 38 patients with osteoporosis were collected.A total of 580 segments of intervertebral disc and endplate morphology were counted.In the intervertebral disc,there were 141 type I degeneration,accounting for 24.3%;type II degeneration,108,accounting for 18.6%;type ? degeneration,159,accounting for 27.4%;type IV degeneration,125,accounting for 21.6%;47 of the V-type degeneration,accounting for 8.1%;the Pfirrmann integral of the shanm was 11.19±2.11,the Pfirmann integral of the osteopenia was 12.83±1.74,and the Pfirrmann integral of the osteoporosis was 16.76±1.43.The degree of osteoporosis was positively correlated with disc degeneration(r=0.428,P<0.001).In all the statistics of the end plates,there are 172 concave types,accounting for 29.7%,334 flat types,accounting for 57.6%,and 74 irregular shapes,accounting for 12.8%.The endplate score of the sham was 8.2 1±1.34;the endplate score of the osteopenia was 8.89±1.21;the endplate of the osteoporosis was 10.451±2.01.There was a positive correlation between the degree of osteoporosis and the degree of endplate degeneration(r=0.428,P<0.001).In the normal intervertebral disc,the concave end plate accounted for 44.7%,the flat type accounted for 48.9%,and the irregular type accounted for 6.3%.In the degenerative intervertebral disc,the concave type accounted for 24.8%;the flat type accounted for 60.3%;the irregular type accounted for 14.8%.Conclusion:Osteoporosis is associated with the degeneration of lumbar vertebra.The degree of degeneration of lumbar intervertebral disc is high,and the shape of endplate is flat or irregular.Intervertebral disc degeneration is closely related to endplate morphology.