To determine if the mechanical properties of the annulus fibrosus (AF) are altered following end-plate fracture. Vertebral fractures, particularly those in the growth plate, are relatively common among adolescents. What is unclear is whether or not these fractures are also associated with concomitant damage to the intervertebral disc (IVD), in particular the AF.
The current study employed a high-rate IVD pressurization model to create growth plate fractures in the porcine cervical spine. Posterior AF mechanical properties and laminate adhesion strength were quantified in fractured spines and compared to samples obtained from non-pressurized, un-fractured spines.
AF laminate adhesion strength was 31% lower in the fractured spines compared to the un-fractured spines.
This decrease in laminate adhesion strength suggests that growth plate fracture damage is not isolated to the vertebra and results in microdamage to the interlamellar matrix of the AF. This may increase in the risk of progressive delamination of the AF, which is associated with IVD herniation.
These slides can be retrieved under Electronic Supplementary Material.
This is a preview of subscription content, access via your institution.
Buy single article
Instant access to the full article PDF.
Tax calculation will be finalised during checkout.
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
Tax calculation will be finalised during checkout.
Sucato DJ (2004) Back pain in children and adolescents. In: Frymoyer JW, Wiesel SW (eds) The adult and pediatric spine, vol 1, 3rd edn. Lippincott Williams & Wilkins, Philadelphia, pp 445–461
Molina V, Court C, Dagher G, Pourjamasb B, Nordin JY (2004) Fracture of the posterior margin of the lumbar spine: case report after an acute, unique, and severe trauma. Spine 29:E565–E567
Clark P, Letts M (2001) Trauma to the thoracic and lumbar spine in the adolescent. Can J Surg 44(5):337–345
Ikata T, Morita T, Katoh S, Tachibana K, Maoka H (1995) Lesions of the lumbar posterior end plate in children and adolescents. An MRI study. J Bone Jt Surg Br 77(6):951–955
Epstein NE, Epstein JA (1991) Limbus lumbar vertebral fractures in 27 adolescents and adults. Spine 16:962–966
Takata K, Inoue S, Takahashi K, Ohtsuka Y (1988) Fracture of the posterior margin of a lumbar vertebral body. J Bone Jt Surg Am 70(4):589–594
Aufdermaur M (1974) Spinal injuries in juveniles: necropsy findings in twelve cases. J Bone Jt Surg Br 56B(3):513–519
Sairyo K, Goel VK, Grobler LJ, Ikata T, Katoh S (1998) The pathomechanism of isthmic lumbar spondylolisthesis. A biomechanical study in immature calf spines. Spine 23:1442–1446
Kajiura K, Katoh S, Sairyo K, Ikata T, Goel VK, Murakami RI (2001) Slippage mechanism of pediatric spondylolysis: biomechanical study using immature calf spines. Spine 26:2208–2212
Bick EM, Copel JW (1951) The ring apophysis of the human vertebra; contribution to human osteogeny II. J Bone Jt Surg Am 33-A(3):783–787
Brown SH, Gregory DE, McGill SM (2008) Vertebral end-plate fractures as a result of high rate pressure loading in the nucleus of the young adult porcine spine. J Biomech 41(1):122–127
Lundin O, Ekström L, Hellström M, Holm S, Swärd L (2000) Exposure of the porcine spine to mechanical compression: differences in injury pattern between adolescents and adults. Eur Spine J 9(6):466–471
Veres SP, Robertson PA, Broom ND (2008) Microstructure and mechanical disruption of the lumbar disc annulus. Part II: how the annulus fails under hydrostatic pressure. Spine 33(25):2711–2720
Acosta FL Jr, Metz L, Adkisson HD, Liu J, Carruthers-Liebenberg E, Milliman C, Maloney M, Lotz JC (2011) Porcine intervertebral disc repair using allogeneic juvenile articular chondrocytes or mesenchymal stem cells. Tissue Eng Part A 17(23–24):3045–3055
Wade KR, Robertson PA, Broom ND (2011) A fresh look at the nucleus-endplate region: new evidence for significant structural integration. Eur Spine J 20(8):1225–1232
Brown S, Rodrigues S, Sharp C, Wade K, Broom N, McCall IW, Roberts S (2016) Staying connected: structural integration at the intervertebral disc–vertebra interface of human lumbar spines. Eur Spine J 26(1):248–258
Monaco LA, DeWitte-Orr SJ, Gregory DE (2016) A comparison between porcine, ovine, and bovine intervertebral disc anatomy and single lamella annulus fibrosus tensile properties. J Morphol 277(2):244–251
Bezci SE, Nandy A, O’Connell GD (2015) Effect of hydration on healthy intervertebral disk mechanical stiffness. J Biomech Eng 137(10):101007
McNally DS, Adams MA (1992) Internal intervertebral disc mechanics as revealed by stress profilometry. Spine 17(1):66–73
Wade KR, Robertson PA, Thambyah A, Broom ND (2014) How healthy discs herniate: a biomechanical and microstructural study investigating the combined effects of compression rate and flexion. Spine 39(13):1018–1028
Veres SP, Lee JM (2012) Designed to fail: a novel mode of collagen fibril disruption and its relevance to tissue toughness. Biophys J 102(12):76–2884
Wilke HJ, Kienle A, Maile S, Rasche V, Berger-Roscher N (2016) A new dynamic six degrees of freedom disc-loading simulator allows to provoke disc damage and herniation. Eur Spine J 25(5):1363–1372
Berger-Roscher N, Casaroli G, Rasche V, Villa T, Galbusera F, Wilke HJ (2017) Influence of complex loading conditions on intervertebral disc failure. Spine 42(2):E78–E85
Pezowicz CA, Schechtman H, Robertson PA, Broom ND (2006) Mechanisms of anular failure resulting from excessive intradiscal pressure: a microstructural–micromechanical investigation. Spine 31(25):2891–2903
Baranto A, Ekström L, Holm S, Hellström M, Hansson HA, Swärd L (2005) Vertebral fractures and separations of endplates after traumatic loading of adolescent porcine spines with experimentally-induced disc degeneration. Clin Biomech 20(10):1046–1054
Thoreson O, Baranto A, Ekström L, Holm S, Hellström M, Swärd L (2010) The immediate effect of repeated loading on the compressive strength of young porcine lumbar spine. Knee Surg Sports Traumatol Arthrosc 18(5):694–701
Gregory DE, Callaghan JP (2011) A comparison of uniaxial and biaxial mechanical properties of the annulus fibrosus: a porcine model. J Biomech Eng 133(2):024503
Gregory DE, Bae WC, Sah RL, Masuda K (2014) Disc degeneration reduces the delamination strength of the annulus fibrosus in the rabbit annular disc puncture model. Spine J 14(7):1265–1271
Chang CH, Lee ZL, Chen WJ, Tan CF, Chen LH (2008) Clinical significance of ring apophysis fracture in adolescent lumbar disc herniation. Spine 33(16):1750–1754
Singhal A, Mitra A, Cochrane D, Steinbok P (2013) Ring apophysis fracture in pediatric lumbar disc herniation: a common entity. Pediatr Neurosurg 49(1):16–20
Maxfield BA (2010) Sports-related injury of the pediatric spine. Radiol Clin N Am 48(6):1237–1248
Choi W, Song S, Chae S, Ko S (2017) Comparison of the extent of degeneration among the normal disc, immobilized disc, and immobilized disc with an endplate fracture. Clin Orthop Surg 9(2):193–199
Balkovec C, Adams MA, Dolan P, McGill SM (2015) Annulus fibrosus can strip hyaline cartilage end plate from subchondral bone: a study of the intervertebral disk in tension. Glob Spine J 5(5):360–365
Zehra U, Bow C, Lotz JC, Williams FMK, Rajasekaran S, Karppinen J, Luk KDK, Battiê MC, Samartzis D (2017) Structural vertebral endplate nomenclature and etiology: a study by the ISSLS Spinal Phenotype Focus Group. Eur Spine J. https://doi.org/10.1007/s00586-017-5292-3
Oxland TR, Panjabi MM, Southern EP, Duranceau JS (1991) An anatomic basis for spinal instability: a porcine trauma model. J Orthop Res 9:452–462
Yingling VR, Callaghan JP, McGill SM (1999) The porcine cervical spine as a model of the human lumbar spine: an anatomical, geometric, and functional comparison. J Spinal Disord 12(5):415–423
Wilke HJ, Geppert J, Kienle A (2011) Biomechanical in vitro evaluation of the complete porcine spine in comparison with data of the human spine. Eur Spine J 20(11):1859–1868
Peh WC, Griffith JF, Yip DK, Leong JC (1998) Magnetic resonance imaging of lumbar vertebral apophyseal ring fractures. Australas Radiol 42(1):34–37
Conflict of interest
The author(s) declare that they have no competing interests.
Ethical and informed consent
Animal tissue was obtained from an abattoir and therefore ethical and informed consent is not necessary.
Funding was provided by Natural Sciences and Engineering Research Council of Canada.
Electronic supplementary material
Below is the link to the electronic supplementary material.
About this article
Cite this article
Snow, C.R., Harvey-Burgess, M., Laird, B. et al. Pressure-induced end-plate fracture in the porcine spine: Is the annulus fibrosus susceptible to damage?. Eur Spine J 27, 1767–1774 (2018). https://doi.org/10.1007/s00586-017-5428-5
- Intervertebral disc
- Apophyseal ring fracture