Characteristics and natural course of vertebral endplate signal (Modic) changes in the Danish general population.
BMC Musculoskelet Disord. 2009;10:81
Publication Type
Tue S Jensen
Tom Bendix
Joan S Sorensen
Claus Manniche
Lars Korsholm
Per Kjaer
Author Affiliation
The Back Research Center, Ringe, Denmark.
BMC Musculoskelet Disord. 2009;10:81
Publication Type
Disease Progression
Health Surveys
Intervertebral Disc - pathology
Logistic Models
Lumbar Vertebrae - pathology
Magnetic Resonance Imaging
Observer Variation
Predictive value of tests
Prospective Studies
Reproducibility of Results
Spinal Diseases - pathology
Time Factors
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.
Cites: Radiology. 2001 Feb;218(2):420-711161156
Cites: Eur Spine J. 2008 Nov;17(11):1407-2218787845
Cites: Spine (Phila Pa 1976). 2002 Jan 15;27(2):125-3411805656
Cites: Spine (Phila Pa 1976). 2002 Oct 15;27(20):2274-812394906
Cites: Radiology. 2004 May;231(2):352-815064391
Cites: Skeletal Radiol. 2004 Jul;33(7):399-40415138721
Cites: Eur Radiol. 2004 Sep;14(9):1574-8115060839
Cites: AJR Am J Roentgenol. 1987 Sep;149(3):531-43497539
Cites: Radiology. 1988 Jan;166(1 Pt 1):193-93336678
Cites: Radiology. 1988 Jul;168(1):177-863289089
Cites: Spine (Phila Pa 1976). 1995 May 1;20(9):1029-357631232
Cites: Skeletal Radiol. 1996 Feb;25(2):119-268848739
Cites: Spine (Phila Pa 1976). 1996 Apr 15;21(8):936-408726196
Cites: J Magn Reson Imaging. 1997 Sep-Oct;7(5):880-69307915
Cites: Acta Radiol. 1998 Jan;39(1):18-239498863
Cites: Radiology. 1998 Dec;209(3):661-69844656
Cites: Skeletal Radiol. 2005 Mar;34(3):125-915647940
Cites: Acta Radiol. 2005 Feb;46(1):83-815841744
Cites: Spine (Phila Pa 1976). 2005 May 15;30(10):1173-8015897832
Cites: Eur J Radiol. 2005 Jun;54(3):431-715899347
Cites: Spine (Phila Pa 1976). 2005 Aug 15;30(16):1867-916103857
Cites: Rofo. 2006 Jan;178(1):46-5416392057
Cites: Spine J. 2006 Mar-Apr;6(2):177-8416517390
Cites: Spine (Phila Pa 1976). 2006 Jul 1;31(15):1714-816816768
Cites: Spine (Phila Pa 1976). 2006 Sep 1;31(19):2250-716946663
Cites: Eur Spine J. 2006 Sep;15(9):1312-916896838
Cites: Acta Radiol. 2006 Nov;47(9):947-5317077047
Cites: Spine (Phila Pa 1976). 2006 Nov 1;31(23):2701-617077739
Cites: J Manipulative Physiol Ther. 2007 Feb;30(2):85-9017320728
Cites: Spine (Phila Pa 1976). 2007 May 1;32(10):1116-2217471095
Cites: Eur Spine J. 2007 Jul;16(7):977-8217334791
Cites: Acta Radiol. 2007 Sep;48(7):748-5417729006
Cites: Spine (Phila Pa 1976). 2007 Oct 1;32(21):E603-717906561
Cites: Med Hypotheses. 2008;70(2):361-817624684
Cites: Spine (Phila Pa 1976). 2007 Dec 1;32(25):2812-918246002
Cites: Spine (Phila Pa 1976). 2008 Feb 1;33(3):273-918303459
Cites: BMC Musculoskelet Disord. 2008;9:5118416819
Cites: Eur Spine J. 2008 Oct;17(10):1300-818648860
Cites: Radiology. 2001 May;219(2):368-7411323459
PubMed ID
19575784 View in PubMed
Less detail