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Vertebral Endplate

lamina terminalis vertebrae

The vertebral endplate is the thin cartilaginous and bony interface between the vertebral body and the intervertebral disc, consisting of a hyaline cartilage layer overlying a thin cortical bone plate with central perforations. The endplate is the critical interface for disc nutrition (by diffusion through the cartilaginous plate from vertebral body vasculature) and for load transfer between the disc and vertebra. Its structural integrity determines disc health and its failure produces Schmorl's nodes (disc herniation through the endplate).

Anatomical Data

Structure & Landmarks

Articulations	Intervertebral disc (cartilaginous layer) Vertebral body cancellous bone (bony plate)
Landmarks	Central zone: thinnest, most permeable, most vulnerable to fracture Peripheral zone: thicker, vascularised in childhood, avascular in adults Anterior and posterior thirds: most commonly fractured in osteoporosis Schmorl's node: endplate defect with intravertebral disc herniation
Ossification	A ring apophysis forms around the margin of each endplate, appearing at about 8-12 years and fusing with the vertebral body by about 18-25 years.

Clinical Relevance

Clinical Notes

Modic changes (MRI signal changes adjacent to vertebral endplates in disc degeneration) are graded I (acute, T1 dark/T2 bright, vascular reactive change), II (chronic, T1 bright/T2 bright, fatty replacement), and III (sclerotic, T1 and T2 dark, eburnation), reflecting progressive endplate pathology from disc degeneration. Modic type I changes correlate with discogenic back pain and are a target for intradiscal injection therapy. Osteoporotic vertebral compression fractures primarily involve the anterior vertebral endplate, leading to anterior wedge collapse visible on radiograph.

Pathology

Common Injuries & Conditions

Modic Type I Endplate Changes as Discogenic Pain Source

Acute inflammatory Modic I changes at the vertebral endplate (T1 hypointense, T2 hyperintense on MRI) represent vascular fibrovascular tissue in fissured endplate adjacent to a degenerated disc and correlate with axial discogenic back pain; intradiscal corticosteroid or antibiotic treatment targets the inflammatory endplate response in selected patients.

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