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Year : 2022  |  Volume : 29  |  Issue : 1  |  Page : 22-26

Vertebral end-plate changes: Are they clinically significant for postoperative low back pain?

1 Department of Radiology, Doruk Private Hospital, Bursa, Turkey
2 Department of Radiology, Malatya Darende State Hospital, Malatya, Turkey
3 Department of Radiology, Suleyman Demirel University School of Medicine, Isparta, Turkey
4 Department of Neurosurgery, Uludag University School of Medicine, Bursa, Turkey

Correspondence Address:
Dr. Rukan Karaca
Department of Radiology, Malatya Darende State Hospital, Malatya
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/wajr.wajr_31_21

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Background: Our aim was to assess the relationship between postoperative recurrent low back pain and vertebral body end-plate signal intensity changes on magnetic resonance imaging in disc herniation patients. Materials and Methods: The preoperative magnetic resonance images of 748 patients were retrospectively reviewed. End-plate changes were separated into three groups according to the Modic classification. The postoperative clinical improvement was defined according to the Kawabata criteria. The localization and type of end-plate degeneration and improvement after the operation were analyzed with Pearson's Chi-square test. Results: End-plate degeneration was found in 394 of 748 patients. Single-level and multiple-level end-plate changes were present in 70.4% and 29.6% of the patients, respectively. Type 2 (85.5%), type 1 (10.7%), and type 3 (3.8%) degenerations were encountered in order of frequency. The severities of the end-plate changes were mild, moderate, and severe in 63.2%, 32.7%, and 4.1% of the patients. Type 1 and type 2 degenerations correlated with clinical course in the postoperative period (P < 0.05). Conclusions: Type 1 and type 2 degenerative end-plate changes seen on preoperative magnetic resonance scans can influence the clinical course and be an indicator of postoperative back pain.

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