• Xian He, Anjing Liang, Wenjie Gao, Yan Peng, Liangming Zhang, Guoyan Liang, and Dongsheng Huang.
• Department of Orthopedics, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, #107 Yanjiang Rd. West, Guangzhou, Guangdong, China.
• Spine. 2012 Aug 1;37(17):E1068-73.

Study DesignA retrospective study of magnetic resonance imaging of the lower lumbar spine.ObjectiveTo describe the characteristics of the concave angle of vertebral endplate (CAVE) and study the association between CAVE and lumbar intervertebral disc degeneration (IVDD).Summary Of Background DataThe vertebral endplate is responsible for transferring stress between disc and vertebral body, and its concavity is important in dispersing compression stress. However, the characteristics of CAVE and the relationship between CAVE and IVDD have not been investigated.MethodsMagnetic resonance images of the lower lumbar spine in 511 patients with low back pain were examined by 2 experienced spine surgeons. The grades of IVDD and lumbar disc herniation (LDH) were evaluated, several parameters including CAVE, height, and the sagittal diameter of vertebral body were measured, and the association between IVDD or LDH and CAVE was analyzed.ResultsAt L3-L4, L4-L5, and L5-S1, CAVE was smaller in the upper endplate (i.e., the inferior endplate of the superior vertebra) than in the lower endplate (i.e., the superior endplate of the inferior vertebra). There was no male/female difference in the size of CAVE in any of the segments. According to partial correlation analysis, CAVE was moderately related to IVDD, but no association between CAVE and LDH was found.ConclusionWhen lumbar IVDD occurs, the CAVE increases and the endplate tends to flatten. The degree of flattening is related to the severity of the degeneration.

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