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Characteristics and natural course of vertebral endplate signal (Modic) changes in the Danish general population.

https://arctichealth.org/en/permalink/ahliterature149899
Source
BMC Musculoskelet Disord. 2009;10:81
Publication Type
Article
Date
2009
Author
Tue S Jensen
Tom Bendix
Joan S Sorensen
Claus Manniche
Lars Korsholm
Per Kjaer
Author Affiliation
The Back Research Center, Ringe, Denmark. Tue.Secher.Jensen@shf.regionsyddanmark.dk
Source
BMC Musculoskelet Disord. 2009;10:81
Date
2009
Language
English
Publication Type
Article
Keywords
Adult
Denmark
Disease Progression
Female
Health Surveys
Humans
Intervertebral Disc - pathology
Logistic Models
Lumbar Vertebrae - pathology
Magnetic Resonance Imaging
Male
Observer Variation
Predictive value of tests
Prospective Studies
Reproducibility of Results
Spinal Diseases - pathology
Time Factors
Abstract
Vertebral endplate signal changes (VESC) are more common among patients with low back pain (LBP) and/or sciatica than in people who are not seeking care for back pain. The distribution and characteristics of VESC have been described in people from clinical and non-clinical populations. However, while the clinical course of VESC has been studied in patients, the natural course in the general population has not been reported. The objectives of this prospective observational study were to describe: 1) the distribution and characteristics of VESC in the lumbar spine, 2) its association with disc degeneration, and 3) its natural course from 40 to 44 years of age.
Three-hundred-and-forty-four individuals (161 men and 183 women) sampled from the Danish general population had MRI at the age of 40 and again at the age of 44. The following MRI findings were evaluated using standardised evaluation protocols: type, location, and size of VESC, disc signal, and disc height. Characteristics and distribution of VESC were analysed by frequency tables. The association between VESC and disc degeneration was analysed by logistic regression analysis. The change in type and size of VESC was analysed by cross-tabulations of variables obtained at age 40 and 44 and tested using McNemar's test of symmetry.
Two-thirds (67%) of VESC found in this study were located in the lower part of the spine (L4-S1). VESC located at disc levels L1-L3 were generally small and located only in the anterior part of the vertebra, whereas those located at disc levels L4-S1 were more likely to extend further into the vertebra and along the endplate. Moreover, the more the VESC extended into the vertebra, the more likely it was that the adjacent disc was degenerated. The prevalence of endplate levels with VESC increased significantly from 6% to 9% from age 40 to 44. Again, VESC that was only observed in the endplate was more likely to come and go over the four-year period compared with those which extended further into the vertebra, where it generally persisted.
The prevalence of VESC increased significantly over the four-year period. Furthermore, the results from this study indicate that the distribution of VESC, its association with disc degeneration and its natural course, is dependent on the size of the signal changes.
Notes
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PubMed ID
19575784 View in PubMed
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Degenerative Pathways of Lumbar Motion Segments--A Comparison in Two Samples of Patients with Persistent Low Back Pain.

https://arctichealth.org/en/permalink/ahliterature274229
Source
PLoS One. 2016;11(1):e0146998
Publication Type
Article
Date
2016
Author
Rikke K Jensen
Per Kjaer
Tue S Jensen
Hanne Albert
Peter Kent
Source
PLoS One. 2016;11(1):e0146998
Date
2016
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Child
Cross-Sectional Studies
Denmark - epidemiology
Disease Progression
Female
Humans
Intervertebral Disc Degeneration - epidemiology - pathology - physiopathology
Intervertebral Disc Displacement - epidemiology - pathology - physiopathology
Low Back Pain - epidemiology - etiology - pathology - physiopathology
Lumbar Vertebrae - pathology
Magnetic Resonance Imaging
Male
Middle Aged
Motion
Nerve Compression Syndromes - epidemiology - pathology - physiopathology
Spinal Nerve Roots - pathology
Spinal Osteophytosis - epidemiology - pathology - physiopathology
Spinal Stenosis - epidemiology - pathology - physiopathology
Spondylolisthesis - epidemiology - pathology - physiopathology
Young Adult
Abstract
Magnetic resonance imaging (MRI) is used to identify spinal pathoanatomy in people with persistent low back pain. However, the clinical relevance of spinal degenerative MRI findings remains uncertain. Although multiple MRI findings are almost always present at the same time, research into the association with clinical outcomes (such as pain) has predominantly focused on individual MRI findings. This study aimed to: (i) investigate how multiple MRI lumbar spine findings cluster together within two different samples of patients with low back pain, (ii) classify these clusters into hypothetical pathways of degeneration based on scientific knowledge of disco-vertebral degeneration, and (iii) compare these clusters and degenerative pathways between samples.
We performed a secondary cross-sectional analysis on two dissimilar MRI samples collected in a hospital department: (1) data from the spinal MRI reports of 4,162 low back pain patients and (2) data from an MRI research protocol of 631 low back pain patients. Latent Class Analysis was used in both samples to cluster MRI findings from lumbar motion segments. Using content analysis, each cluster was then categorised into hypothetical pathways of degeneration.
Six clusters of MRI findings were identified in each of the two samples. The content of the clusters in the two samples displayed some differences but had the same overall pattern of MRI findings. Although the hypothetical degenerative pathways identified in the two samples were not identical, the overall pattern of increasing degeneration within the pathways was the same.
It was expected that different clusters could emerge from different samples, however, when organised into hypothetical pathways of degeneration, the overall pattern of increasing degeneration was similar and biologically plausible. This evidence of reproducibility suggests that Latent Class Analysis may provide a new approach to investigating the relationship between MRI findings and clinically important characteristics such as pain and activity limitation.
Notes
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PubMed ID
26807697 View in PubMed
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