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Intervertebral disc degeneration - an autopsy study

  • V. L. Fornasier
  • G. Garaffo
  • L. Denaro
  • V. Denaro
Original articles

Abstract

This is an autopsy analysis of 126 thoracolumbar spines. Extensive histomorphological examination identified microscopic changes in the nucleus and annulus fibrosus before any gross or radiological changes were evident. Histomorphological evidence of microavulsion of the attachment of the annulus fibrosus from its mooring at the margin of the cartilaginous endplate of the vertebral body suggests that forces (compression, distraction, rotation) applied during movement are contributing factors to the pathogenesis of degenerative disc disease.

Key words

Intervertebral disc Degeneration Spine 

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References

  1. 1.
    Anstadt GW (1991) Intervertebral disc degeneration. J Occupat Med 33: 582–583Google Scholar
  2. 2.
    Fornasier VL, Horne JG (1975) Metastases to the vertebral column. Cancer 36: 590–594PubMedGoogle Scholar
  3. 3.
    Coventry MB, Ghormley RK, Kernohan JW (1945) The intervertebral disc: its microscopic anatomy and pathology. Part II - Changes in the intervertebral disc concomitant with age. J Bone Joint Surg 27: 233–247; Part III - Pathological changes in the intervertebral disc. J Bone Joint Surg 27: 460–474Google Scholar
  4. 4.
    Coventry MB (1969) Anatomy of the intervertebral disc. Clin Orthop 67: 9–15PubMedGoogle Scholar
  5. 5.
    Fornasier VL, Czitrom AA (1978) Collapsed vertebrae - a review of 659 autopsies. Clin Orthop Rel Res 131: 261–265Google Scholar
  6. 6.
    Gill K, Lesh PC, Videman T (1986) Comparison of MRI, CT scan, discography and macroscopic anatomy in the evaluation of cadaveric lumbar discs. Intl Soc Study Lumbar Spine Dallas, TexasGoogle Scholar
  7. 7.
    Schmorl G, Junghanns H (1971) The human spine in health and disease. Grune & Stratton, New YorkGoogle Scholar
  8. 8.
    Hirabayashi S, Kumano K, Tsuiki T, Eguchi M, Ikeda S (1990) A dorsally displaced free fragment of lumbar disc herniation and its interesting histologic findings. Spine 15: 1231–33PubMedGoogle Scholar
  9. 9.
    Horn V, Vlach O, Messner P (1991) Enthesopathy in the vertebral disc region. Arch Orthop Trauma Surg 110: 187–189PubMedGoogle Scholar
  10. 10.
    Urowitz EPM, Fornasier VL (1979) Autoimmunity in degenerative disc disease - a histopathological study. Clin Orthop 142: 215–218PubMedGoogle Scholar
  11. 11.
    Chitkara YK (1991) Clinicopathologic study of changes in prolapsed intervertebral discs. Arch Pathol Lab Med 115: 481–483PubMedGoogle Scholar
  12. 12.
    Reymond RD, Wheeler PS (1972) The lucent cleft, a new radiographic sign of cervical disc injury disease. Clin Radio 23: 188–192Google Scholar
  13. 13.
    Fornasier VL, Littlejohn G, Urowitz MB, Keystone EC, Smythe HA (1984) Spinal enthesial new bone formation: the early changes of spinal diffuse idiopathic skeletal hyperostosis. J Rheumatol 10: 939–947Google Scholar
  14. 14.
    Harris RI, Macnab I (1954) Structural changes in the lumbar intervertebral discs. J Bone Joint Surg 36B: 304–322Google Scholar
  15. 15.
    Osti OL, Vernon-Roberts B, Fraser RD (1990) Annulus tears and intervertebral disc degeneration- an experimental study using an animal model. Spine 15: 762–767PubMedGoogle Scholar
  16. 16.
    Frymoyer JW, Newberg A, et al. (1984) Spine radiographs in patients with low back pain. An epidemiological study in men. J Bone Joint Surg 66 Am: 1048–55PubMedGoogle Scholar
  17. 17.
    Keller RH (1974) Traumatic displacement of the cartilaginous vertebral rim: a sign of intervertebral disc prolapse. Radiol 110: 21–4Google Scholar
  18. 18.
    Hilton RC, Ball J, Benn RT (1980) Annulus tears in the dorsolumbar spine. Ann Rheum Dis 39: 533–538PubMedGoogle Scholar
  19. 19.
    Lawson JP, Ogden JA, et al (1987) Physeal injuries of the cervical spine. J Pediat Orthop 7: 428–35Google Scholar
  20. 20.
    Boni M, Denaro V (1987) Anatomo-clinical correlations in cervical spondylosis. Springer, Berlin Heidelberg New York, pp. 3–20Google Scholar
  21. 21.
    Bohrer SP, Chen YM (1988) Cervical spine annulus vacuum. Skel Radiol 17: 324–329Google Scholar
  22. 22.
    Gardner RC (1970) The lumbar intervertebral disc: a clinicopathological correlation based on over 100 laminectomies. Arch Surg 100: 101–104PubMedGoogle Scholar
  23. 23.
    Koreska J, Robertson D, et al (1977) Biomechanics of the lumbar spine and its clinical significance. Orthop Clin North Am 8: 121–33PubMedGoogle Scholar
  24. 24.
    Knutsson F (1942) The vacuum phenomena in the intervertebral discs. Acta Radio 23173–179Google Scholar
  25. 25.
    Maldague BE, Noel HM, Malghem JJ (1978) The intervertebral vacuum cleft: a sign of ischaemic collapse. Radiol 129: 23–29Google Scholar
  26. 26.
    Raines JR (1953) Intervertebral disc fissures, (vacuum intervertebral disc). Am J Roentgenol 70: 964–966Google Scholar
  27. 27.
    Resnick D, Niwayama G, et al (1981) Spinal vacuum phenomena: anatomical study and review. Radiol 139: 341–348Google Scholar
  28. 28.
    Scully RE, Mark EJ, McNeely WF, McNeely BU (1991) Case records of the Massachusetts General Hospital - Case 37. N Engl J Med 325: 794–799PubMedGoogle Scholar
  29. 29.
    Tervonen O, Videman T (1988) Comparison of ultrasound and discography for the evaluation of disc changes. An experimental study. Springer, Berlin Heidelberg New YorkGoogle Scholar
  30. 30.
    Toyohiko I, Miyasaka K, et al (1983) Computed tomographic findings of vacuum phenomena in cervical intervertebral discs. Surg Neurol 19: 528–531PubMedGoogle Scholar
  31. 31.
    MacNab I (1971) The traction spur, an indicator of segmental instability. J Bone Joint Surg 53: 663–70PubMedGoogle Scholar
  32. 32.
    Hindman BW, Poole CA (1970) Early appearance of the secondary vertebral ossification centers. Radiol 95: 359–361Google Scholar
  33. 33.
    Fornasier VL (1975) Fine detail radiography in the examination of tissue. Human Path 6: 623–631PubMedGoogle Scholar
  34. 34.
    Wu H-C, Ren-Feng Y (1976) Mechanical behaviour of the human annulus fibrosus. J Biomech 9: 1–7PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2000

Authors and Affiliations

  • V. L. Fornasier
  • G. Garaffo
    • 1
  • L. Denaro
    • 2
  • V. Denaro
    • 3
  1. 1.Staff SurgeonGiarre HospitalCatania, SicilyItaly
  2. 2.Orthopaedic Pathology, Laboratory of Bone and Joint Pathology, Department of PathologyWellesley Central Site, St. Michael's Hospital, University of TorontoCanada
  3. 3.Department of Orthopaedic Surgery, Campus Bio MedicoFree University of RomeRomaItaly

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