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11.02.2023 | Original Article

The association between vertebral endplate defects, subchondral bone marrow changes, and lumbar intervertebral disc degeneration: a retrospective, 3-year longitudinal study

verfasst von: Manuel Moser, Dominik Adl Amini, Leonardo Albertini Sanchez, Lisa Oezel, Henryk Haffer, Maximilian Muellner, Jiaqi Zhu, John A. Carrino, Jennifer Shue, Andrew A. Sama, Frank P. Cammisa, Federico P. Girardi, Alexander P. Hughes

Erschienen in: European Spine Journal | Ausgabe 7/2023

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Abstract

Purpose

To investigate the influence of vertebral endplate defects and subchondral bone marrow changes on the development of lumbar intervertebral disc degeneration (DD).

Methods

Patients > 18 y/o without any history of lumbar fusion who had repeat lumbar magnetic resonance imaging scans primarily for low back pain (LBP) performed at a minimum of 3 years apart at a single institution, and no spinal surgery in between scans were included. Total endplate score (TEPS), Modic changes (MC), and Pfirrmann grading (PFG) per lumbar disc level were assessed. DD was defined as PFG ≥ 4.

Results

Three hundred and fifty-three patients (54.4% female) were included in the final analysis, comprising 1765 lumbar intervertebral discs. The patient population was 85.6% Caucasian with a median age of 60.1 years and a body mass index (BMI) of 25.8 kg/m². A cutoff score of 5 was identified for the TEPS above which both the prevalence of DD and the odds of developing DD increased. The probability of developing DD did not differ significantly between lumbar disc levels (P = 0.419). In the multivariable analysis with adjustments for age, sex, race, body mass index (BMI), MC, TEPS cutoff > 5, and spinal level, only age (OR = 1.020; P = 0.002) was found to be an independent risk factor for developing intervertebral DD.

Conclusion

Our results suggest that TEPS does not unequivocally predict intervertebral DD in patients with LBP, since higher degrees of endplate defects might also develop secondarily to DD, and MC tend to occur late in the cascade of degeneration.

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Titel: The association between vertebral endplate defects, subchondral bone marrow changes, and lumbar intervertebral disc degeneration: a retrospective, 3-year longitudinal study
verfasst von: Manuel Moser
Dominik Adl Amini
Leonardo Albertini Sanchez
Lisa Oezel
Henryk Haffer
Maximilian Muellner
Jiaqi Zhu
John A. Carrino
Jennifer Shue
Andrew A. Sama
Frank P. Cammisa
Federico P. Girardi
Alexander P. Hughes
Publikationsdatum: 11.02.2023
Verlag: Springer Berlin Heidelberg
Erschienen in: European Spine Journal / Ausgabe 7/2023
Print ISSN: 0940-6719
Elektronische ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-023-07544-4

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The association between vertebral endplate defects, subchondral bone marrow changes, and lumbar intervertebral disc degeneration: a retrospective, 3-year longitudinal study