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Contribution of the Endplates to Disc Degeneration

  • Intervertebral Disk Degeneration and Regeneration (MV Risbud, Section Editor)
  • Published:
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Abstract

Purpose of Review

The endplates form the interface between the rigid vertebral bodies and compliant intervertebral discs. Proper endplate function involves a balance between conflicting biomechanical and nutritional demands. This review summarizes recent data that highlight the importance of proper endplate function and the relationships between endplate dysfunction, adjacent disc degeneration, and axial low back pain.

Recent Findings

Changes to endplate morphology and composition that impair its permeability associate with disc degeneration. Endplate damage also associates with disc degeneration, and the progression of degeneration may be accelerated and the chronicity of symptoms heightened when damage coincides with evidence of adjacent bone marrow lesions.

Summary

The endplate plays a key role in the development of disc degeneration and low back pain. Clarification of the mechanisms governing endplate degeneration and developments in clinical imaging that enable precise evaluation of endplate function and dysfunction will distinguish the correlative vs. causative nature of endplate damage and motivate new treatments that target pathologic endplate function.

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Funding

This work was supported by the National Institutes of Health (AJF: AR070198; JCL: R01 AR063705).

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, University of California, 513 Parnassus Avenue, S-1161, San Francisco, CA, 94143-0514, USA

    Aaron J. Fields, Alexander Ballatori, Ellen C. Liebenberg & Jeffrey C. Lotz

  2. Department of Orthopaedic Surgery, University of California, 513 Parnassus Avenue, S-1157, San Francisco, CA, 94143-0514, USA

    Aaron J. Fields, Alexander Ballatori, Ellen C. Liebenberg & Jeffrey C. Lotz

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  1. Aaron J. Fields
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  2. Alexander Ballatori
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  3. Ellen C. Liebenberg
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Correspondence to Aaron J. Fields or Jeffrey C. Lotz.

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Aaron J. Fields reports a grant from the National Institutes of Health (NIH/NIAMS R01 AR070198). Alexander Ballatori and Ellen C. Liebenberg each declare no potential conflict of interest. Jeffrey C. Lotz is co-founder and has shares in Relievant Mesystems.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Intervertebral Disk Degeneration and Regeneration

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Fields, A.J., Ballatori, A., Liebenberg, E.C. et al. Contribution of the Endplates to Disc Degeneration. Curr Mol Bio Rep 4, 151–160 (2018). https://doi.org/10.1007/s40610-018-0105-y

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