![]() Therefore, we hypothesized that the occurrence of endplate and/or IVD injuries has a significant effect on the process of bone union following OVFs. Therefore, the altered biomechanical properties of the IVD after an OVF with endplate injury are speculated to enhance the structural inconsistency of the spinal column. Conversely, the stress distribution of vertebrae has been shown to be dependent on the biomechanical properties of IVDs. ![]() Previous biomechanical studies have shown that damage to the VB and/or endplate altered the stress profiles within IVDs with high-stress concentrations in the posterior annulus. ![]() Therefore, the endplate-IVD complex is closely interrelated with the VB in the structural integrity of the anterior spinal column, including biomechanical and biological functions. The endplates, especially the cartilaginous layer, serve as a semipermeable interface that regulates nutritional transport from VB to IVD tissues. The endplates play a crucial role in maintaining the stress-strain relationship between adjacent vertebrae and support the integrity of IVD tissues. The endplate-intervertebral disc (IVD) complex that is interposed between VBs is the basic unit of the anterior spinal column comprising spinal integrity. Įndplate and/or IVD injuries are usually found in association with VFs, however little is known about their relevance to the fracture healing of OVFs. Magnetic resonance imaging (MRI) signal alteration patterns within vertebral bodies (VBs) during the early phase of OVFs have recently been shown to predict an increased risk of delayed union. The healing of OVFs is considered to be influenced by the fracture site (vertebra), global alignment, bone strength (bone mineral density and bone quality), blood supply to the fractured vertebra, bone metabolism and other factors. Conservative treatments have generally been selected for osteoporotic VFs (OVFs), however the rate of non-union has been reported to range from 10 to 30% (see review in ), and some patients require invasive surgeries because of progressive vertebral collapse and/or delayed neurologic deficit with deterioration of quality of life. ![]() Vertebral fractures (VFs) are the most common skeletal injury resulting from osteoporosis within the increasing population of elderly individuals. These results suggest that fracture healing of OVFs would be mainly attributed to vertebral factors, including mechanical stress and metabolic status, among the three components of the anterior spinal column. The results of this study showed that endplate and IVD injuries were found in approximately 60% of single and acute OVFs. Although no significant association with endplate and IVD injuries was identified, multivariate analysis demonstrated that intravertebral signal alternation (focal high signal intensity) and posterior wall injury were independent risk factors that predicted delayed union. In association with OVFs, endplate injuries were observed in 103 of the 168 vertebrae (61%), and IVDs lesions were observed in 101 of 168 OVFs (60%) the occurrence of both injuries was significantly associated. Vertebral MRI signal alternation patterns and endplate and IVD injuries were included as candidate factors in the logistic model. To identify factors predicting delayed union, uni- and multivariate statistical analyses were performed. Vertebrae of 85 patients, who received conservative treatment for acute OVFs, were included in the study and classified into two groups, union and delayed union, at 6 months after injury. The occurrence rate and type of endplate and IVD injuries were radiologically evaluated, and the association between endplate and IVD injuries was statistically analyzed. Vertebrae of 168 patients were included in the study. MethodsĮndplate and IVD injuries associated with single- and acute-OVFs were retrospectively evaluated using magnetic resonance imaging (MRI). The first purpose of this study was to evaluate the incidence and occurrence pattern of endplate and IVD injuries associated with single- and acute-OVFs, and the second was to evaluate the influence of endplate and IVD injuries on the occurrence of delayed union. Endplate and IVD injuries are usually found in association with vertebral fractures (VFs) however, little is known about their relevance to the healing of osteoporotic VFs (OVFs). The endplate-intervertebral disc (IVD) complex is closely interrelated with the vertebral body (VB) in the structural integrity of the anterior spinal column, including biomechanical and biological functions.
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