Prevalence of Vertebral Endplate Modic Changes in Degenerative Lumbar Scoliosis and Its Associated Factors Analysis

Wu, Hailong; Ding, Wenyuan; Shen, Yong; Zhang, Yingze; Guo, Junfei; Sun, Yapeng; Cao, Ling

doi:10.1097/brs.0b013e31825bfb85

Cited by 49 publications

(30 citation statements)

References 22 publications

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“…Some studies have shown that intervertebral disc degeneration is inseparably linked with cartilaginous endplate degeneration [14,31] and Modic changes [47]. The cartilaginous endplate is indispensable to maintain the structural and functional integrity of local structures in the lower lumbar vertebral bodies [34].…”

Section: Discussionmentioning

confidence: 99%

The NLRP3/Caspase-1/Interleukin-1β Axis Is Active in Human Lumbar Cartilaginous Endplate Degeneration

Tang

Zhu

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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Background Modic changes are the MRI signal changes of degenerative lumbar vertebral endplate and which lead to or accelerate intervertebral disc degeneration. NLRP3, caspase-1, and interleukin-1b (IL-1b) play a pivotal role in the pathogenesis of many inflammatory diseases, such as osteoarthritis. However, the roles of IL-1b and its activators caspase-1 and NLRP3 are unclear in the degenerative endplate.Questions/purposes We asked: (1) What are the degenerative changes of the histologic features and chondrogenic markers' gene expressions between the cartilaginous endplates of patients with Modic changes and trauma (control)? (2) How does the NLRP3/caspase-1/IL-1b axis in the cartilaginous endplates of patients with Modic changes compare with control (trauma) specimens? Methods Surgical specimens of cartilaginous endplates were divided into Modic changes (n = 56) and the trauma control (n = 16) groups. Hematoxylin and eosin and safranin O staining of cartilaginous endplate tissues were done to evaluate the extracellular matrix. Reverse transcription-polymerase chain reaction was performed on these tissues to investigate mRNA expression of type II collagen (Col II), SOX-9, matrix metalloproteinase-3, and a disintegrin like and metalloproteinase thrombospondin type I motifs-5. NLRP3, caspase-1, and IL-1b were evaluated by reverse transcription-polymerase chain reaction and immunohistochemistry. Results Hematoxylin and eosin and safranin O staining showed the extracellular matrix degraded in the cartilaginous endplates of patients with Modic changes but not in the control cartilaginous endplates. Chondrogenic Col II (p = 0.024) and SOX9 (p = 0.053) were downregulated in the Modic changes group compared with the control group. In contrast to the control group, the transcriptional levels of

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Section: Discussionmentioning

confidence: 99%

The NLRP3/Caspase-1/Interleukin-1β Axis Is Active in Human Lumbar Cartilaginous Endplate Degeneration

Tang

Zhu

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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“…Many previous papers 2,10,11,16 associated with MCs in the lumbar spine have been published, but most of them are focused on the relationship between MCs and low-back pain. 5,14,17 Some previous studies 1,8,15 demonstrated the relationship between nonfusion after surgery and MCs, and have reported on the instability related to bone marrow changes without using MCs.…”

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confidence: 99%

Motion characteristics and related factors of Modic changes in the lumbar spine

Hayashi

Daubs

Suzuki

et al. 2015

SPI

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OBJECT Most studies of Modic changes (MCs) have focused on investigating the relationship between MCs and lowback pain, whereas the kinematic characteristics and degenerative disc disease associated with MCs are not well understood. To the authors' knowledge, no previous study has reported on the kinematics of MCs. The purpose of this study was to elucidate the relationship of MCs to segmental motion and degenerative disc disease. METHODS Four hundred fifty symptomatic patients underwent weight-bearing lumbar kinematic MRI in the neutral, flexion, and extension positions. Segmental displacement and intervertebral angles were measured in 3 positions using computer analysis software. Modic changes, disc degeneration, disc bulging, spondylolisthesis, angular motion, and translational motion were recorded, and the relationship of MCs to these factors was analyzed using a logistic regression model. To control the influence of disc degeneration on segmental motion, angular and translational motion were analyzed according to mild and severe disc degeneration stages. The motion characteristics and disc degeneration among types of MCs were also evaluated. RESULTS Multivariate analysis revealed that age, disc degeneration, angular motion, and translational motion were factors significantly related to MCs. In the severe disc degeneration stage, a significant decrease of angular motion and significant increase of translational motion were found in segments with MCs, indicating that a disorder of the endplate had an additional effect on segmental motion. Disc degeneration increased and angular motion decreased significantly and gradually as the type of MC increased. Translational motion was significantly increased with Type 2 MCs. CONCLUSIONS Age, disc degeneration, angular motion, and translational motion were significantly linked to MCs in the lumbar spine. The translational motion of lumbar segments increased with Type 2 MCs, whereas angular motion decreased as the type of MC increased, indicating that Type 2 MCs may have translational instability likely due to degenerative changes. A disorder of the endplates could play an important role in spinal instability.

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“…The first patient had more than a year follow-up and the second patient had more than a 4-year follow-up with continued resolution of the pain and return to full physical activities. at the apex vertebrae which is characteristically similar to the Modic changes of adult degenerative scoliosis [4]. This characteristic can be explained by the asymmetrical biomechanical loading at the endplate resulted from scoliosis and different type of forces on the endplate (compression force on concave side and tension force on convex side).…”

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confidence: 67%

“…An increase in the intervertebral shear forces from instability from the congenital scoliosis introduce possibility of endplate trauma and promoted the intervertebral disc and vertebral endplate degeneration [4]. Therefore, we considered instability resulting in endplate degeneration as the cause of pain in these congenital scoliosis patients.…”

Section: Discussionmentioning

confidence: 99%

Unusual presentation of vertebral endplate Modic changes in congenital scoliosis associated with pain: a report of two cases

Siribumrungwong

Gupta

2015

Eur Spine J

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Congenital scoliosis is not normally associated with pain in young children. We are presenting two cases of young patients with congenital scoliosis and moderate to severe pain. There were no spinal cord abnormalities found in these patients. The magnetic resonance imaging and CT scan revealed disc degeneration with Modic changes at the apex of the congenital scoliosis. We hypothesized that the mechanical instability resulting from poor spinal element formations associated with congenital scoliosis was responsible for causing the disc degeneration and endplate changes. Modic changes have been reported to be associated with pain in degenerative conditions of the spine. Both patients underwent a posterior spinal fusion and instrumentation, which relieved their pain immediately.

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Prevalence of Vertebral Endplate Modic Changes in Degenerative Lumbar Scoliosis and Its Associated Factors Analysis

Abstract: The prevalence of MCs in patients with DLS was significantly higher than that of patients without DLS. Most of them were type 2 and usually located on the concave side of apex vertebrae. MCs were significantly associated with intervertebral disc degeneration and lumbar scoliosis.

Cited by 49 publications

References 22 publications

The NLRP3/Caspase-1/Interleukin-1β Axis Is Active in Human Lumbar Cartilaginous Endplate Degeneration

The NLRP3/Caspase-1/Interleukin-1β Axis Is Active in Human Lumbar Cartilaginous Endplate Degeneration

Motion characteristics and related factors of Modic changes in the lumbar spine

Unusual presentation of vertebral endplate Modic changes in congenital scoliosis associated with pain: a report of two cases

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