Factors involved in the nutrition of the human lumbar intervertebral disc: cellularity and diffusion of glucose in vitro.

Post-mortem specimens of the human lumbar (L4-L5) intervertebral disc have been studied histologically and physico-chemically. Blood vessels were found only at the margin of the anulus fibrosus and in the vertebral marrow spaces. Contact between disc tissue and marrow spaces occupied about 10% of the bone-cartilage interface. The disc was most cellular at the periphery of the anulus fibrosus and in the hyaline cartilage next to the vertebral bone. Cellularity declined towards the nucleus pulposus where it achieved a low constant value. The cell density of the disc as a whole was about 60000 cells/mm3. For glucose, the diffusion coefficient of the anulus fibrosus and hyaline cartilage end plate was 2.5 cm2/sec and 2.4 cm2/sec respectively at 37 degrees C, comparable to that of cartilage elsewhere. The permeability of the bone-cartilage interface was low, particularly in the peripheral part. Calculations, based on the present findings and derived values for glucose utilization in disc tissue, indicate that nutritional conditions in the intervertebral disc are more critical than, for example, in articular cartilage.