Document Detail

Longitudinal study of vertebral type-1 end-plate changes on MR of the lumbar spine.
MedLine Citation:
PMID:  15060839     Owner:  NLM     Status:  MEDLINE    
The purpose of this study was to investigate the temporal evolution of type-1 end-plate changes on MRI in patients with degenerative disease of the lumbar spine and to evaluate whether any correlation exists between such evolution and the change in patients' symptoms. Forty-four patients with 48 Modic type-1 end-plate changes (low TI signal and high T2 signal) were studied. All patients had an initial and a follow-up non-contrast lumbar MRI with variable intervals between the studies (12-72 months). Severity of the end-plate changes was assessed by eyeball estimation. Correlation with patients' symptoms was studied with the help of the Visual Analogue Score (VAS), Oswestry Questionnaire Score (OQS) and patients' subjective assessment. Of the 48 disc levels with type-1 changes, 18 (37.5%) converted fully to type 2 (high T1 signal and intermediate to high T2 signal), 7 (14.6%) partially converted to type 2, 19 (39.6%) became worse (i.e. type 1 changes became more extensive) and 4 (8.3%) showed no change. Higher average VAS (5.7) and OQS (42.3) scores were noted in patients where there was worsening type-1 change and lower scores (3.8 and 27, respectively) were seen in those where there was conversion to type-2 change. These trends, however, did not reach statistical significance (P values 0.16 and 0.09 for VAS and OQS, respectively). The statistical relationship was stronger after exclusion of patients with confounding factors (i.e. changes in lumbar MRI other than end-plate changes that could independently explain the evolution of patients' symptoms) with P-values of 0.08 and 0.07 for VAS and OQS, respectively. Type-1 end-plate change represents a dynamic process and in a large majority of cases either converts to type-2 change or becomes more extensive. The evolution of type-1 change relates to change in patient's symptoms, but not to a statistically significant level.
D Mitra; V N Cassar-Pullicino; I W McCall
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Publication Detail:
Type:  Journal Article     Date:  2004-04-02
Journal Detail:
Title:  European radiology     Volume:  14     ISSN:  0938-7994     ISO Abbreviation:  Eur Radiol     Publication Date:  2004 Sep 
Date Detail:
Created Date:  2004-08-18     Completed Date:  2005-01-31     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9114774     Medline TA:  Eur Radiol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  1574-81     Citation Subset:  IM    
Department of Neuroradiology, Newcastle General Hospital, Westgate Road, NE4 6BE Newcastle upon Tyne, UK.
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MeSH Terms
Disease Progression
Intervertebral Disk / pathology*
Longitudinal Studies
Low Back Pain / classification,  diagnosis
Lumbar Vertebrae / pathology*
Magnetic Resonance Imaging*
Middle Aged
Pain Measurement
Sciatica / classification,  diagnosis
Spinal Osteophytosis / classification,  diagnosis*
Statistics as Topic

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