Gullbrand Laboratory

Etiology of Disc Degeneration Across the Motion Segment

The intervertebral discs of the spine are the largest avascular structures in the body. Cells within the disc therefore rely on the transport of nutrients and waste products across the vertebral endplate to maintain disc homeostasis. A compromise in transport across the vertebral endplate interface is therefore implicated in the initiation and progression of disc degeneration. The overarching goal of this project is twofold: 

  1. Elucidate the properties of the boney and cartilage endplates that affect trans-endplate transport and how alterations in transport contribute to disc degeneration
  2. Investigate alterations to trans-endplate transport and disc health during non-operative treatment of patients with back pain and their correlation with pain relief and functional outcomes. 
Microscale remodeling of the cartilage-endplate interface: Mallory-Heidenhaim trichrome staining of the boney endplate (EP) and cartilaginous nucleus pulposus (NP) on three samples of different Pfirman grades (5 assigned to more severe degeneration than 2) (scale bar = 1,000 ┬Ám).
MRI T2 relaxation maps of human donor spines in various states of degeneration.

Our group seeks to accomplish these goals by determining how the structural, mechanical, and compositional properties of the vertebral endplates affect diffusion and convection into both healthy and degenerative human intervertebral discs. Additionally, the Gullbrand Lab will quantify the effect of physical therapy on trans-endplate diffusion into the degenerative disc in patients with back pain in order to establish correlations between disc health, nutrition, and patient outcomes.


VA RR&D CDA2 - IK2 RX003118 - The role of disc nutrition in the etiology and clinical treatment of disc degeneration 

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