Endplate lesions in the lumbar spine: a novel MRI-based classification scheme and epidemiology in low back pain patients

Marco Brayda-Bruno, Domenico Albano, Guglielmo Cannella, Fabio Galbusera, Alberto Zerbi

Research output: Contribution to journalArticle

Abstract

Purpose: The aims of the study were to introduce a classification scheme for endplate lesions based on T2-weighted magnetic resonance imaging and to detect possible associations between endplate lesions and other variables such as age, sex, disc degeneration and Modic changes in a large population. Methods: MRI images of 996 low back pain patients were collected. All intervertebral spaces were classified as “normal”, “wavy/irregular”, “notched”, “Schmorl’s node” and “fracture”. The associations between endplate lesions and age, sex, disc degeneration and Modic changes were determined in the considered population. Results: The most common endplate lesions were “notched” and “Schmorl’s nodes”. The prevalence was higher among the male subjects. In most patients (62.8%), no endplate lesions were detected, with a significant difference between male (57.5%) and female subjects (67.9%) (p < 0.001). Lesions were found to be associated with intervertebral disc degeneration (relative risk 2.49) and signal alterations (relative risk 3.08). Fleiss kappas of 0.73 and 0.89 were, respectively, assessed for the inter- and intra-observer reliabilities of the new classification system. Conclusions: Endplate lesions were detected, classified with a novel scheme and analysed in a large population of patients suffering from low back pain based on MRI images. The reliability of the novel classification system was demonstrated. Graphical abstract: These slides can be retrieved under Electronic Supplementary Material.[Figure not available: see fulltext.].

Original languageEnglish
Pages (from-to)2854-2861
Number of pages7
JournalEuropean Spine Journal
Volume27
Issue number11
DOIs
Publication statusPublished - Nov 2018

Keywords

  • Classification system
  • Endplate defects
  • Endplate lesions
  • Modic changes
  • Pfirrmann grading

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Fingerprint Dive into the research topics of 'Endplate lesions in the lumbar spine: a novel MRI-based classification scheme and epidemiology in low back pain patients'. Together they form a unique fingerprint.

  • Cite this