• Yiming Zhang, Yiming Dou, Yuanzhi Weng, Chao Chen, Qingqian Zhao, Wentao Wan, Hanming Bian, Ye Tian, Yang Liu, Shan Zhu, Zhi Wang, Xinlong Ma, Xinyu Liu, Weijia William Lu, and Qiang Yang.
• Department of Spine Surgery, Tianjin Hospital, Tianjin University, Tianjin, China; Clinical School of Orthopedics, Tianjin Medical University, Tianjin, China.
• World Neurosurg. 2024 Oct 15.

BackgroundOsteoporosis and degenerative disc disease (DDD) are prevalent in the elderly population. Damage to the vertebral endplate, which impairs nutrient supply to the disc, serves as both a significant initiator and a hallmark of DDD. This study was aimed to explore the association between osteoporosis and endplate damage.MethodsThis retrospective study included 205 patients with DDD who were treated at Tianjin Hospital from January 2019 to May 2023. We collected data on age, sex, body mass index, phantom-less quantitative computed tomography (PL-QCT) values, and total endplate scores (TEPS). The average PL-QCT value of L1-L4 and TEPS were used to represent volumetric bone mineral density (BMD) and the degree of endplate damage, respectively. Based on the average PL-QCT value of L1 and L2, patients were divided into 3 groups: normal group (BMD > 120 mg/cm3), osteopenic group (80 mg/cm3 ≤ BMD ≤ 120 mg/cm3), and osteoporosis group (BMD < 80 mg/cm3). Multiple linear regression models were used to identify independent factors associated with endplate damage.ResultsThe overall TEPS (4.3 ± 1.3 vs. 5.0 ± 1.0 vs. 5.9 ± 1.5, P < 0.01) and segment (L1/2-L4/5) TEPS (P < 0.05) in each group showed significant difference (R = -0.5), increasing in order from normal group to osteoporosis group. A significant negative correlation was found between TEPS and PL-QCT values in overall and each segment (P < 0.001). The PL-QCT values and age (P < 0.05) were independent factors influencing endplate damage. There were significant differences in the average number of TEPS ≥7 segments per patient among the 3 groups, with 1.16, 0.41, and 0.2 segments/person from osteoporosis group to normal group.ConclusionsOur study showed a significant positive correlation between osteoporosis and endplate damage. Attention is warranted for patients with osteopenia to prevent progression to osteoporosis, potentially leading to exacerbated DDD. The management of patients with both DDD and osteoporosis necessitates comprehensive treatment strategies that address both the BMD and endplate aspects of these conditions.Copyright © 2024 Elsevier Inc. All rights reserved.

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