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. 2022 Aug;16(5):792-799.
doi: 10.14444/8336. Epub 2022 Aug 31.

Sagittal Plane Geometry of Cervical, Thoracic, and Lumbar Endplates

Rangel Roberto de Assis  1 , Marcello Nogueira Barbosa  2 , Helton L A Defino  3
Affiliations

Sagittal Plane Geometry of Cervical, Thoracic, and Lumbar Endplates

Rangel Roberto de Assis et al. Int J Spine Surg. 2022 Aug.

Abstract

Background: Many studies have emphasized the importance of interface contact between implants and the vertebral endplate (VE). The goal of this study was to analyze the shape and other specific parameters of the VE to provide reference data for better implant interface contact in intervertebral disc space procedures.

Methods: Cervical, thoracic, and lumbar spine midsagittal plane magnetic resonance images of 100 adults (58 women) were analyzed. The morphology of the VEs was classified as concave, convex, flat, or irregular. Midsagittal endplate length (ML), endplate concavity depth (ECD), and endplate concavity axis (ECA) location were measured in the midsagittal plane. The parameters were compared between the cervical, thoracic, and lumbar spines and between the sexes.

Results: The VE morphology, ML, ECD, and ECA showed variations along the spine, mainly in the cervical and lower lumbar spines. The sagittal geometry of the VE was not flat or uniform along the cervical, thoracic, and lumbar spines. Different morphological types were observed along different spinal segments and according to sex. In the cervical spine, the majority of cranial VEs were flat, while caudal VEs were mostly concave.

Conclusion: Sagittal VE geometry should be taken into consideration during the use of intervertebral cages or disc arthroplasty.

Keywords: MRI; cervical; endplate; lumbar spine; sagittal geometry; thoracic.

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Conflict of interest statement

Declaration of Conflicting Interests: The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Types of vertebral endplates (VEs) according to the morphology: (A) concave, (B) convex, (C) flat, and (D) irregular. In the flat type, the entire extension of the VE was contained in the line that joined the anterior and posterior corners of the vertebral body. In the concave type, the deepest part of the VE was located at least 1 mm deep in relation to the line that joined the anterior and posterior corners of the vertebral body. In the convex type, part of the plate was located at least 1 mm from the reference line. In the irregular type, the plate was at least one point above and one point below the reference line. The nomenclature describing the cranial and caudal VEs refers to the vertebral body. Cranial VEs are on the cranial side and the caudal endplates are on the caudal side of the vertebral body.
Figure 2
Figure 2
Sagittal magnetic resonance imaging of lumbar spine illustrating (A) flat, (B) concave, and (C) convex vertebral endplates.
Figure 3
Figure 3
Distribution of vertebral endplate shapes in the cervical, lumbar, and thoracic spines.
Figure 4
Figure 4
Midsagittal length in the cervical, lumbar, and thoracic spine.
Figure 5
Figure 5
Endplate concavity depth (ECD) in the cervical, lumbar, and thoracic spine.
Figure 6
Figure 6
Endplate concavity axis (ECA) in the cervical, lumbar, and thoracic spine.
See this image and copyright information in PMC

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