Decrease with aging of the microcirculatory function of the lumbar vertebral marrow preceding the loss of bone material density and the onset of intervertebral discal degeneration: A study about the potential cause

OBJECTIVE Using a dynamic computed tomographic perfusion (CTP) imaging method to explore the age-related distribution of the microcirculation perfusion function in the vertebral marrow, the bone material density (BMD), and the intervertebral discal degeneration (IDD). Further, to discuss a possible causation relationship between them. METHODS One hundred and eighty-six people were randomly enrolled by stratified sampling and grouped by age: ≤15, 16-25, 26-35, 36-45, 46-55, 56-65, 66-75, and ≥76 years old. The average CTP and BMD of the third and fourth lumbar vertebrae marrow were measured and the IDD incidence of the third-fourth vertebrae was assessed. The temporal-spatial distribution patterns of the age-related changes of the CTP, BMD, and IDD were described, and the correlations between them were calculated. RESULTS The microcirculatory perfusion function of the vertebral marrow develops to maturity by 25 years and is maintained until age 35, then declines with aging. The BMD grew to a peak from 26 to 45 years old, then decreased yearly. The IDD showed a sudden increase after 45 years of age. The CTP [BF (r = 0.806, P = 0.000), BV (r = 0.685, P = 0.005) and PMB (r = 0.619, P = 0.001)] showed strong positive correlations and CTP [TTP (r = -0.211, P = 0.322) and MTT (r = -0.598, P = 0.002)] showed negative correlations with BMD. The CTP [BF (r = -0.815, P = 0.000), BV (r = -0.753, P = 0.000) and PMB (r = -0.690, P = 0.000)] had strong negative correlations, and CTP [TTP (r = 0.323, P = 0.126) and MTT (r = 0.628, P = 0.001)] had positive correlations with the incidence of IDD. CONCLUSION The decrease with aging of the microcirculatory perfusion in the lumbar vertebral marrow preceded, and is a potential causative factor for the loss of BMD and the onset of IDD.