Vertebral Endplate Changes Are Not Associated with Chronic Low Back Pain among Southern European Subjects: A Case Control Study

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Fig 1.
Modic II from a 50-year-old asymptomatic subject who was included in the control group. Sagittal T1- (A) and T2-weighted (B) images show hyperintensity in both endplates of the L4-L5 space, associated with signs of disk degeneration.

Table 1:

MR imaging protocol

Protocol
All examinations were performed on six 1.5T MR imaging systems with a 6-channel phased array spine coil. The following sequences were used without fat suppression:
• A localizer sequence of 5 images, 30 ms/10 ms/50° (TR/TE/flip angle) consisting of 2 coronal and 3 sagittal images in orthogonal planes
• Sagittal T1-weighted spin-echo, 440–550 ms/14–20 ms (TR/TE), 156–307 × 192–512 matrix, 270-mm FOV, 11 sections of 4-mm thickness, 2 acquisitions
• Sagittal T2-weighted turbo spin-echo 2896–3300 ms/102–120 ms (TR/TE_eff), 156–307 × 192–512 matrix, 270-mm FOV, 11 sections of 4-mm thickness, 2 acquisitions, echo-train length of 12
• Axial T2-weighted turbo spin-echo 2896–3040 ms/103–120 ms (TR/TE_eff), 224–190 × 256–512 matrix, 180-mm FOV, 15 sections of 5-mm thickness, 3 acquisitions, echo-train length of 5. Sections were placed in the plane of the 5 lower disks

Table 2:

Sample characteristics

Variable	No.^{^a}	Patients with LBP (240 Subjects)	No.^{^a}	Subjects without LBP (64 Subjects)
Age (range) (yr)^{^b}	240	43 (38–47)	64	45 (41–47)
Sex^{^c}	240		64
Male (median)		108 (45)		35 (54.7)
Female (median)		132 (55)		29 (45.3)
BMI (range) (Kg/m²)^{^b}	228	24.6 (22.4–27.3)	60	25.2 (21.9–27.4)
Lifetime smoking (pack-years) (range)^{^b}	224	2.3 (0.0–11.2)	60	3 (0–11)
Highly intense physical activity (median)^{^c}	199	51 (25.6)	48	9 (18.8)
Low back pain severity (VAS) (range)^{^b}	229	4 (2–7)	52	0 (0–0)
Duration of pain (range) (mo)	185	46 (11–112)	64
Disability (range) (RMQ)^{^b}	213	6 (3–12)	6	1 (1–1)
Vertebral endplate changes (any type)^{^c,^d}	240	193 (80.4)	64	56 (87.5)
Types of vertebral endplate changes^{^c}	193		56
Only type I		10 (4.2)		1 (1.6)
Types I and II		38 (15.8)		14 (21.9)
Types I and III		2 (0.8)		0 (0.0)
Type I, II, and III		11 (4.6)		0 (0.0)
Only type II		120 (50.0)		40 (62.5)
Types II and III		11 (4.6)		0 (0.0)
Only type III		1 (0.4)		1 (1.6)
No. of vertebral endplate changes per patient^{^b}	240	2 (1; 3)	64	3 (2; 4)
Severe disk degeneration^{^c}	240	158 (65.8)	64	30 (46.9)

↵a No. of subjects in each group for whom data on the corresponding variable were available (subjects who answered the corresponding question or in whom the variable was applicable—eg, age, sex, weight, height, patients who showed any type of vertebral endplate change or severe disk degeneration, and so forth).
↵b Median (P25, P75).
↵c No. (%).
↵d P value for the comparison of the proportion of vertebral endplate changes among subjects without LBP, compared with those with LBP: .191.