S-Space College of Medicine/School of Medicine (의과대학/대학원) Orthopedic Surgery (정형외과학전공) Journal Papers (저널논문_정형외과학전공)
Herniation of Cartilaginous Endplates in the Lumbar Spine: MRI Findings
- Joe, Eugene; Lee, Joon Woo; Park, Kun Woo; Yeom, Jin Sup; Lee, Eugene; Lee, Guen Young; Kang, Heung Sik
- Issue Date
- American Roentgen Ray Society (ARRS)
- American Journal of Roentgenology, vol.204 no.5, pp. 1075-1081
- OBJECTIVE. The purpose of this study was to determine reliable MRI findings suggesting
disk herniation with cartilage endplate herniation in the lumbar spine.
MATERIALS AND METHODS. The records of 73 patients who underwent lumbar spinal
MRI and lumbar microdiskectomy between March 2005 and January 2009 were searched
to find those with the diagnosis of disk herniation with cartilage endplate herniation confirmed
during surgery. The following morphologic features were assessed: posterior corners
(posterior marginal nodes, dorsal corner defects, Modic changes, and posterior osteophytes),
mid endplates (endplate irregularities, Modic changes), and heterogeneous low signal intensity
of extruded material. The chi-square test and multiple logistic regression analysis with
age, body mass index, and sex as covariates were used for the analysis. The ROC curve was
obtained with scores of the statistically significant MRI findings.
RESULTS. Posterior marginal nodes, posterior osteophytes, Modic changes in posterior
corners, mid endplate irregularities, Modic changes in mid endplates, and heterogeneous low
signal intensity of extruded material were significantly more frequent in patients with disk
herniation with cartilage endplate herniation (0.000 < p < 0.009). The AUC for diagnosing
disk herniation with cartilage endplate herniation with our scoring system of the six MRI
findings (0–6) was 0.888.
CONCLUSION. The presence of disk herniation with cartilage endplate herniation
could be ascertained with the following MRI findings: posterior marginal nodes, posterior
osteophytes, mid endplate irregularities, heterogeneous low signal intensity of extruded material,
and Modic changes in posterior corners and mid endplates.
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