What is endplate disease of the spine?
2 When endplates begin to deteriorate, inflammation increases and lesions can develop. Studies have found evidence that such lesions on endplates in the lumbar region of the back are associated with low back pain. 3 In its advanced stages, endplate degeneration is called endplate sclerosis.
Are endplate changes painful?
“Modic endplate changes were initially described in 1988 but fell into disuse due to a lack of successful treatments associated with the changes. With the evidence endplates are a significant source of pain, Modic type 1 and type 2 changes are once again in the clinical limelight,” said Dr.
What are endplate changes in spine?
Background. Vertebral endplate (Modic) changes are bone marrow and endplate lesions visible in magnetic resonance imaging (MRI). They are shown to be associated with degenerative intervertebral disc disease [1–3].
What causes endplate changes?
Modic changes in the bones of the spine or the end-plates occur in response to degenerative changes in the discs, pathology, or infections. Degenerative changes within the disc are the most common cause of Modic changes diagnosed through magnetic resonance imaging.
What are endplates?
The end plate is a bilayer of cartilage and bone that separates the intervertebral disks from the adjacent vertebrae (Fig. 1A to C).
What is degenerative endplate?
Endplate degeneration represents a continuum of different stages of degeneration beginning with bone edema and ending with the endplate sclerosis.
What are endplate irregularities?
Endplate Irregularity Observations The most common irregularities noted were rim degeneration (50 %) and avulsions (35%). Nodes were less common (15%) and found mostly in the thoracic spine, where the avulsions and rim degenerations were found in the lumbar spine samples.
What is Type 1 endplate change?
Modic type I endplate change is the most controversial and important of the three types described (see Modic endplate change). It is seen on MRI of the spine and represents the presence of low T1 and high T2 signal within the bone marrow of a vertebral body adjacent to a disk. Type 1 change can enhance and be painful.
Is an endplate fracture a compression fracture?
In vitro studies reveal that the most likely type of failure of this anterior part of the spine is a fracture of the endplate as a result of compression. The high incidence of aspecific low back pain concurs with the likeliness of compression fractures of the endplate to occur in everyday life.
Where is your endplate?
At the cranial and caudal ends of each disc are the endplates that separate the vertebral bone from the disc itself and prevent the highly hydrated nucleus from bulging into the adjacent vertebrae. The endplates also absorb the considerable hydrostatic pressure that results from mechanical loading of the spine .
How can I prevent degenerative disc disease from getting worse?
Preventing Degenerative Disc Disease
- Stop smoking, or better yet, don’t start — smoking increases the rate of desiccation.
- Be active – regular exercise to increase the strength and flexibility of muscles that surround and support the spine.
What can be done for endplate sclerosis?
Thus, the endplate could be one origin of low back pain. Doubtlessly, conservative treatments including medication, physical therapy, bed rest, and massage may be effective for most patients.
What are the protrusions of L5 and S1?
L5 consists of a vertebral body in front and an arch in the back that has 3 bony protrusions: a prominent spinous process in the middle and two transverse processes on the sides. These protrusions serve as attachment points for ligaments. S1, also called the sacral base, is the upper and wider end of the triangular-shaped sacrum.
What is an L5 S1 disc?
( (L5 is medical shorthand for the fifth vertebrae in the lumbar, or the lower part of the spine, and S1 denotes the first vertebrae in the sacrum. The L5 S1 disc is sandwiched between these two vertebrae).
Which L4-5 and L5-S1 levels are most commonly affected by endplate degeneration?
The L4-5 and L5-S1 levels are most commonly affected. Vertebral endplate degenerative changes are significantly associated with back pain, with type 1 changes showing the strongest association. 4, 5 Most patients with Modic changes also have concurrent evidence of disc degeneration. 6 Modic changes are rare in asymptomatic patients. 7
What is the L5-S1 motion segment?
The L5-S1 motion segment has distinctive anatomy and receives a higher degree of mechanical stress and loads compared to the segments above. 1 These characteristics may make L5-S1 susceptible to traumatic injuries, degeneration, disc herniation, and/or nerve pain. This motion segment typically includes the following structures: L5 and S1 vertebrae.