Lumbar Vertebral Endplate Defects on Magnetic Resonance Images

Feng, Zhuo; Liu, Yuanhao; Yang, Ge; Battié, Michele C.; Wang, Yue

doi:10.1097/brs.0000000000002450

Cited by 51 publications

(41 citation statements)

References 46 publications

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“…An analysis of the Pfirrmann grading revealed the prevalence of grades in the following percentages: I (0.75%), II (14.25%) III (37.5%), IV (36.5%), and Grade V discs (11%). These research discoveries suggest that our patients had more serious degeneration of lumbar discs in comparison with those reported in other studies (23)(24)(25). For all patients, we summarized all grades and correlated them with ODI and VAS test revealed a significant correlation in the Pfirrmann grades, VAS (p = 0.16), and ODI (p = 0.24).…”

Section: Discussionsupporting

confidence: 71%

Assessment of Lumbar Spine Disc Degeneration in Coherence to Pfirrman Grades and Oswestry Disability Index

Hasanovic-Vučković

Jusufbegović

Vegar-Zubović

et al. 2020

JHSCI

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Introduction: Intervertebral disc (IVD) degeneration (IDD) is one of the main causes of low back pain (LBP). Standardized diagnostic algorithms for adequate estimation and classification of changes of lumbar discs are mandatory before starting with therapy.Methods: One hundred patients who were indicated for lumbar magnetic resonance imaging (MRI) were included in the study. Pfirrmann grading system was used for the determination of IDD, while the visual analog scale (VAS) is used for evaluation of the intensity of LBP. To quantification of disability for LBP, we used the Oswestry Disability Index (ODI).Result: Results showed higher Pfirrmann grades II and III for L2/L3 and L3/L4 lumbar levels and lower scores at L4/L5 and L5/S1. The analysis also showed low scores at the L2/3 and L3/4 lumbar level for Pfirrmann grades IV and V, and there was an increased at more inferior lumbosacral levels L4/5 and L5/S1. There was a significant correlation between Pfirrmann grades and ODI (p = 0.24) as well as VAS (p = 0.16).Conclusion: Higher Pfirrmann grades correlated with increased ODI and VAS. Therefore, MRI can be used as a strong indicator of clinical appearance, but it is important to take into consideration that LBP should be correlated with clinical features. By summing Pfirrmann grades of all lumbar intervertebral levels in each patient, we can get more accurate insight for the status of the lumbar spine.

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Section: Discussionsupporting

confidence: 71%

Assessment of Lumbar Spine Disc Degeneration in Coherence to Pfirrman Grades and Oswestry Disability Index

Hasanovic-Vučković

Jusufbegović

Vegar-Zubović

et al. 2020

JHSCI

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“…Earlier studies have shown, that endplate changes and DDD are related. [20,8] In the present study, no relevant increase of DDD grade was seen during follow up.…”

Section: Discussioncontrasting

confidence: 57%

Incidence and clinical impact of vertebral endplate changes after limited lumbar microdiscectomy and implantation of a bone-anchored annular closure device

Kienzler

Rey

Wetzel

et al. 2020

Preprint

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Background: An annular closure device (ACD) could potentially prevent recurrent herniation by blocking larger annular defects after limited microdiscectomy (LMD). The purpose of this study was to analyze the incidence of endplate changes (EPC) and outcome after LMD with additional implantation of an ACD to prevent reherniation. Methods: This analysis includes data from a) RCT study-arm of patients undergoing LMD with ACD implantation and b) additional patients undergoing ACD implantation at our institution. Clinical findings (VAS,ODI), radiological outcome (reherniation, implant integrity, volume of (EPC) and risk factors for EPC were assessed. Results: Seventy-two patients (37men, 47±11.63yo) underwent LMD and ACD implantation between 2013-2016. A total of 71 (99%) patients presented with some degree of EPC during the follow-up period (14.67±4.77months). In the multivariate regression analysis, localization of the anchor was the only significant predictor of EPC (p=0.038). The largest EPC measured 4.2 cm3. Reherniation was documented in 17 (24%) patients (symptomatic: n=10; asymptomatic: n=7). Six (8.3%) patients with symptomatic reherniation underwent rediscectomy. Implant failure was documented in 19 (26.4%) patients including anchor head breakage (n=1, 1.3%), dislocation of the whole device (n=5, 6.9%), and mesh dislocation into the spinal canal (n=13, 18%). Mesh subsidence within the EPC was documented in 15 (20.8%) patients. Seven (9.7%) patients underwent explantation of the entire, or parts of the device.Conclusion: Clinical improvement after LMD and ACD implantation was proven in our study. High incidence and volume of EPC did not correlate with clinical outcome. Mechanical friction of the polymer mesh with the endplate is most likely the cause of EPC after ACD.

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“…Earlier studies have shown, that endplate changes and DDD are related. [21,8] In the present study, no relevant increase of DDD grade was seen during follow up.…”

Section: Discussioncontrasting

confidence: 57%

Incidence and Clinical Impact of Vertebral Endplate Changes after Limited Lumbar Microdiscectomy and Implantation of a Bone-anchored Annular Closure Device 

Kienzler¹,

Rey

Wetzel

et al. 2020

Preprint

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Background: An annular closure device (ACD) could potentially prevent recurrent herniation by blocking larger annular defects after limited microdiscectomy (LMD). The purpose of this study was to analyze the incidence of endplate changes (EPC) and outcome after LMD with additional implantation of an ACD to prevent reherniation. Methods: This analysis includes data from a) RCT study-arm of patients undergoing LMD with ACD implantation and b) additional patients undergoing ACD implantation at our institution. Clinical findings (VAS,ODI), radiological outcome (reherniation, implant integrity, volume of (EPC) and risk factors for EPC were assessed. Results: Seventy-two patients (37men, 47±11.63yo) underwent LMD and ACD implantation between 2013-2016. A total of 71 (99%) patients presented with some degree of EPC during the follow-up period (14.67±4.77months). In the multivariate regression analysis, localization of the anchor was the only significant predictor of EPC (p=0.038). The largest EPC measured 4.2 cm3. Reherniation was documented in 17 (24%) patients (symptomatic: n=10; asymptomatic: n=7). Six (8.3%) patients with symptomatic reherniation underwent rediscectomy. Implant failure was documented in 19 (26.4%) patients including anchor head breakage (n=1, 1.3%), dislocation of the whole device (n=5, 6.9%), and mesh dislocation into the spinal canal (n=13, 18%). Mesh subsidence within the EPC was documented in 15 (20.8%) patients. Seven (9.7%) patients underwent explantation of the entire, or parts of the device.Conclusion: Clinical improvement after LMD and ACD implantation was proven in our study. High incidence and volume of EPC did not correlate with clinical outcome. The ACD might prevent disc reherniation despite implant failure rates. Mechanical friction of the polymer mesh with the endplate is most likely the cause of EPC after ACD.

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Lumbar Vertebral Endplate Defects on Magnetic Resonance Images

Abstract: 4.

Cited by 51 publications

References 46 publications

Assessment of Lumbar Spine Disc Degeneration in Coherence to Pfirrman Grades and Oswestry Disability Index

Assessment of Lumbar Spine Disc Degeneration in Coherence to Pfirrman Grades and Oswestry Disability Index

Incidence and clinical impact of vertebral endplate changes after limited lumbar microdiscectomy and implantation of a bone-anchored annular closure device

Incidence and Clinical Impact of Vertebral Endplate Changes after Limited Lumbar Microdiscectomy and Implantation of a Bone-anchored Annular Closure Device

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Lumbar Vertebral Endplate Defects on Magnetic Resonance Images

Abstract: 4.

Cited by 51 publications

References 46 publications

Assessment of Lumbar Spine Disc Degeneration in Coherence to Pfirrman Grades and Oswestry Disability Index

Assessment of Lumbar Spine Disc Degeneration in Coherence to Pfirrman Grades and Oswestry Disability Index

Incidence and clinical impact of vertebral endplate changes after limited lumbar microdiscectomy and implantation of a bone-anchored annular closure device

Incidence and Clinical Impact of Vertebral Endplate Changes after Limited Lumbar Microdiscectomy and Implantation of a Bone-anchored Annular Closure Device&nbsp;

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Incidence and Clinical Impact of Vertebral Endplate Changes after Limited Lumbar Microdiscectomy and Implantation of a Bone-anchored Annular Closure Device