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View Full Version : The vertebral endplate: disc degeneration, disc regeneration



titaniumed
08-26-2011, 12:52 AM
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2335377/

Im trying to answer questions I have regarding timing of surgeries, starting to lean in the direction of sooner, rather than later. Also vertrebral wedge causes, which seem to begin or at least have something to do with the contents of this article. Upon reaching skeletal maturity the cartilage of the endplate undergoes substantial remodelling, resulting in extensive mineralisation which is eventually resorbed and replaced by true bone [8, 34]. Importantly this new tissue most likely impedes the hitherto critical diffusion and nutrient exchange between the vertebral marrow and the disc [42]. The small blood vessels within the endplate likewise become obliterated by this calcification, further limiting the exchange of vital nutrients.

I find this interesting since I had “partial corpectomies” done in my lower levels. It is the removal of the endplates of each vertebrae, the removal of the degenerated, calcified, non blood bearing areas needed to promote fusion.
http://medillustrations.com/ImgH.Aspx?spl=24799
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In an animal model of spondylolysis disc degeneration, including loss of the endplate, was seen and was accompanied by increased apoptosis of endplate chondrocytes, indicating possible involvement of programmed cell death in age-related disc degeneration

Could programmed cell death be the reason why some of us suddenly progress (spine falling) at a rapid pace?
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Although it would be completely erroneous to suggest that disc degeneration per se is the sole cause of back pain, it would nonetheless be naive to ignore the strong correlation that exists between the two entities. As a result of exciting developments in the field of spinal research we are now more aware than ever of the cellular processes that occur in disc degeneration, and as we move into the exciting era of “regenerative medicine” or “biological treatments” there is increasing interest and even an expectation that degenerative diseases can be treated by a “magic bullet”.

It would nonetheless be naive to ignore the strong correlation that exists between the two entities.

This really throws a wrench in the gears...another set of parameters in scoliosis. If disc disease and endplate problems cause scoliosis and kyphosis, or at least are a contributing factor, maybe this needs more thought.
Ed

jrnyc
08-26-2011, 03:07 AM
hey...could ya shoot one of those "magic bullets" my way...?
i bet my herniated discs would appreciate it!

jess

Pooka1
08-26-2011, 05:27 AM
I noodled around in that literature just now... apoptosis as applied to bone remodeling.

The complexity of the biochemistry involved in that subject rivals the complexity of the biochemistry of AIS. And that is just for the bone aspect... I didn't even try to find more on the relation between the bone issues as they might affect disc biology.

According to a now 10-year old review article I came across, very little had been established in terms of facts in this area as far as I can tell. Seems to be not a lot of consensus either though there is some.

N.B. It is comical that I am making any remarks whatsoever about this field after just reading a few abstracts. :-)

titaniumed
08-26-2011, 09:49 AM
Jess

If we had that “magic bullet” its doubtful that it would work after the damage is done. Since we are not there yet, it might be best to have surgery before the degeneration destroys the vertebrae.

I wonder what would have happened if I would have continued waiting? If the vertebrae is completely degenerated, that can really present problems especially if its multiple vertebrae in multiple levels. Also. I probably could have avoided my anterior if I would have had surgery before age 40.

Ed

jeneemohler
08-26-2011, 11:33 AM
If only we all had a crystal ball to go along with that magic bullet....ain't hindsight great??? I too, should have had it done a bit sooner....