• World Neurosurg · Sep 2020

    Lumbar vertebral endplate defects on MRI in degenerative spondylolisthesis: Novel classification, characteristics, and correlative factor analysis.

    • Ruoyu Li, Zhiwei Wang, Lei Ma, Dalong Yang, Dongxiao Xie, Botong Zhang, and Wenyuan Ding.
    • Department of Spine Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, China.
    • World Neurosurg. 2020 Sep 1; 141: e423-e430.

    BackgroundEndplate defects are commonly seen in patients with lumbar degenerative disease. However, little is known about the presence of endplate defects in patients with degenerative spondylolisthesis (DS). In the present study, we have introduced a classification system for endplate defects in patients with DS using routine magnetic resonance imaging findings and explored the correlative factors.MethodsEndplate defects were classified into 3 major categories (rim defects, focal defects, and erosive defects) and 5 subtypes (anterior type, posterior type, arc type at the anterior rim, notch type, and Schmorl's nodes). The incidence rates of the endplate defects were compared between the slippage and nonslippage levels. The correlations between the endplate defects and age, sex, disc degeneration, Modic changes (MCs), body mass index, slippage segment, and slippage degree were analyzed.ResultsEndplate defects were present in 47.43% of the endplates in DS. The most common endplate defects were rim defects. The occurrence of endplate defects, especially anterior defects, was more common at the slippage levels. Endplate defects were associated with age and closely related to MCs and the severity of disc degeneration. The slippage degree, slippage segment, body mass index, and sex differences were not associated with endplate defects in our study. The results obtained using this novel classification system were stable and consistent.ConclusionsThe results from the present study have shown that the novel radiological classification system of endplate defects is reliable. Endplate defects were associated with slippage but not with the slippage degree or slippage segment differences in DS. The correlation between endplate defects and age and between MCs and disc degeneration were important features on the magnetic resonance imaging scans of patients with DS.Copyright © 2020 Elsevier Inc. All rights reserved.

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