The Journal of Bone and Joint Surgery, Vol 77, Issue 1 26-31, Copyright © 1995 by Journal of Bone and Joint Surgery, Inc
Ingrowth of blood vessels in disc degeneration. Angiographic and histological studies of cadaveric spines
LI Kauppila
Department of Forensic Medicine, University of Helsinki.
Angiograms were made of twenty-two cadaveric lumbar spines to determine the
presence of any new blood vessels between adjacent lumbar vertebrae and
corresponding discs. The annulus and adjacent longitudinal ligaments were
also analyzed histologically. A total of 105 intervertebral spaces were
studied. It was found that the normal anastomosing arteries in the
posterior longitudinal ligament were significantly obliterated with
advancing degeneration of the disc (p < 0.001), whereas several tiny
tortuous arteries--often running between the osteophytic spurs--were seen
in the anterolateral aspects of the intervertebral spaces connecting the
adjacent vertebrae. Histological examination of the anterolateral part of
the annulus showed that the vascularity of the annulus increased
significantly with degeneration of the disc (p < 0.001), and most of the
arteries had a vertical orientation. Regression analysis showed that
vascular changes occurred before degeneration of the disc at every lumbar
level, suggesting that disturbances in the nutritional supply may precede
degeneration. The correlation coefficient was 0.77 (95 per cent confidence
limit, 0.52 to 0.90) for the increase in annular vascularity with an
increase in the age of the individual at the time of death and 0.86 (95 per
cent confidence limit, 0.69 to 0.94) for the increase in degeneration of
the disc with an increase in age.
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