Relationship between vertebral endplate degeneration (Modic changes, Schmorl nodes, endplate irregularities) and Bone Mineral Density

Objective: The end plate plays an important role in maintaining the structural integrity, balancing biomechanical and supplying nutrition, how dose it changes with the reduced bone mineral density (BMD) remains unknown. The objective of this study is to investigate the relationship between lumbar end plate degeneration and normal BMD, osteopenia and osteoporosis.Methods: A retrospective analysis of 362 patients equal or over 55 years old who underwent both lumbar MRI and dual-energy x-ray absorptiometry(DXA) examinations due to lumbar discomfort or a healthy physical examination. Two Radiologists reported the Modic changes, Schmorl node, and end plate irregularities of 11 end plates from L1 to S1. Data were separated by sex, and then the summed results were grouped in age matching.Results: In women, with the decrease of hip BMD, the positive rate and severity of Modic changes and the severity of end plate irregularities showed an increasing trend; Among men, the number of Modic changes and end plate irregularities increased in osteoporosis subjects and osteopenia subjects compared with normal BMD subjects. While the positive rate of Schmorl nodes incremental trend was not obvious in female and male subjects.Conclusions: Osteoporosis in the elderly will aggravate the degeneration of the lumbar end plate Modic changes and end plate irregularities.