A study published in Spine was recently awarded the International Society for the Study of the Lumbar Spine 2013 Prize for Lumbar Spine Research. The study, conducted by researchers at Hanga Hospital in Tamil, Nadu, India, discovered that most herniated discs in the lower spine are a result of avulsion of tissue connecting the spinal bone and spinal discs. According to MedicalXPress, the results also suggest that future research on herniated discs should focus on avulsed, or separated, end plate junctions. End plate junctions are the attachments between the spinal bone and discs.
Herniated discs, which are also referred to as ruptured or slipped discs, can lead to severe back pain. A disc can become herniated when “the soft material inside the disc (nucleus pulposus) leaks through the tough outer covering of the disc (annulus fibrosis),” according to MedicalXPress. The researchers in the study analyzed available data for 181 patients with herniated discs who were going through surgery for the issue. The researchers also chose to not include patients who were over the age of 60 or patients with multiple disc injuries due to influence from other disc issues.
The data the researchers analyzed included observations from surgery, results from x-rays, computerized tomographic and magnetic resonance imaging scans, and microscopic studies. At the end of their analysis, the researchers determined that in approximately 65 percent of the cases studied, the end point junction had torn off and a piece of bone or cartilage had separated from the disc and vertebrae. Only 11 percent of the patients had a true rupture of the spinal disc. Some cases revealed that an avulsed end point junction actually healed from the initial injury to the time of surgery and repaired the herniated disc. However, sometimes these patients also developed spinal stenosis, a condition in which the spinal canal narrows.
Conventional spinal knowledge suggests that rupturing of the annulus fibrosis is the main way in which disc herniation occurs, but the results of this new study challenge that notion. The researchers wrote that their study shows that end plate junction failure is largely underrated, mostly because it is difficult to find. Moving forward, they say their research on the evidence of widespread end plate junction failure “opens up opportunities for prevention, repair and biological strategies that may prevent progression of lumbar disc herniation after the initial event of herniation.”