Morphological Changes of the Intervertebral Disc During Growth

Aaron J B W D Moens; Joëll Magré; Moyo C Kruyt; René M Castelein; Steven de Reuver

doi:10.1097/BRS.0000000000004795

Morphological Changes of the Intervertebral Disc During Growth

Spine (Phila Pa 1976). 2023 Aug 8. doi: 10.1097/BRS.0000000000004795. Online ahead of print.

Authors

Aaron J B W D Moens¹, Joëll Magré^{1

2}, Moyo C Kruyt¹, René M Castelein¹, Steven de Reuver¹

Affiliations

¹ Department of Orthopedic Surgery, University Medical Center Utrecht, Utrecht, the Netherlands.
² 3D Lab, Division of Surgical Specialties, University Medical Center Utrecht, Utrecht, The Netherlands.

PMID: 37584598
DOI: 10.1097/BRS.0000000000004795

Abstract

Study design: Cross-sectional.

Objective: To describe morphological changes of the annulus fibrosus (AF) and nucleus pulposus (NP) in children during growth using magnetic resonance imaging (MRI).

Summary of background data: Little is known of intervertebral disc (IVD) maturation as opposed to degeneration, such as changes in relative AF/NP proportions and orientation during growth. Studies suggest the IVD plays a role in the etiology of pediatric spinal deformities. Therefore, understanding the morphological development of the AF and NP during growth is key.

Methods: An existing database of children aged 0-18 that had magnetic resonance imaging (MRI) for indications unrelated to the spine were analyzed. The AF/NP were segmented semi-automatically from T1-L5. The parameters: mean IVD height, cross-sectional area, slenderness (height/width ratio), volume (ratio) and relative position of the centroid of the NP within the IVD in three directions (x,y,z) were extracted, and compared between age, sex and spinal level.

Results: IVD height increased modestly and predominantly in the low-thoracic and lumbar spine during the first 5-10 years of life. Cross-sectional area and thus volume increased steadily at all levels throughout growth. IVD slenderness decreased sharply the first years of life and remains relatively stable throughout the remainder of growth. IVDs were smaller and more slender in females, especially in the mid-thoracic spine at early adolescence. In the upper- and mid-thoracic spine the NP comprises 10-12% of total IVD volume during growth, this percentage increases in the low-thoracic and lumbar spine towards 20-25%. In the anterior-posterior direction, the position of the nucleus increasingly shifts with age, possibly in line with the developing sagittal profile of the spine.

Conclusion: This study describes the development of thoracic and lumbar IVDs during growth and may be used as a reference for future studies on the IVD its role in the etiology of disc related disorders.