Abstract
Background: As an important anatomic factor in the process of Lumbar disc herniation (LDH), the correlation between endplate sagittal morphology and intervertebral disc degeneration (IDD) is unclear. and research on imaging data of lumbar endplate in patients with LDH is still insufficient. Our study aimed to observe the morphological change of the lower lumbar endplate (L3-S1) in patients with LDH on magnetic resonance imaging (MRI), and analyze its correlation with the degree of IDD.Methods/Design: All 116 patients were included. Based on their MRI, we divided endplates into three types (concave, flat and irregular), assigned intervertebral discs with Grade I-V given 1-5 points successively according to Pfirrmann system, and determined whether there was Modic change of each endplate. The correlation between the morphology of endplate and the degree of IDD was analyzed.Results: There were excellent inter-observer agreement for each item we analyzed (ICC > 0.75). Concave endplate appeared most frequently (187, 53.7%) and mainly distributed in L3/4 and L4/5, while irregular endplate was the least common type (54, 15.5%) and mainly concentrated in L5/S1. The IDD degree of corresponding disc increased gradually from concave (3.27 ± 0.81) to irregular endplates (4.25 ± 0.79) (P < 0.05). Irregular endplates were more likely to have Modic changes than concave and flat endplates (P < 0.05). Conclusion: The sagittal morphology of lower lumbar endplate is related to Modic changes and degree of IDD (based on Pfirrmann grading system) in patients with LDH, and the concave endplate mostly reflects a lower degree of lumbar disc degeneration, which has substantial clinical significance.
Investigating a Possible Link between MRI Findings of Lumbar Disc Degeneration and Modic Changes in the Patients with Chronic Low Back Pain