University of Oulu

Määttä, J.H., Rade, M., Freidin, M.B. et al. Strong association between vertebral endplate defect and Modic change in the general population. Sci Rep 8, 16630 (2018) doi:10.1038/s41598-018-34933-3

Strong association between vertebral endplate defect and Modic change in the general population

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Author: Määttä, Juhani H.1,2,3; Rade, Marinko4,5,6; Freidin, Maxim B.3;
Organizations: 1Medical Research Center Oulu, Oulu University Hospital and University of Oulu, P.O. Box 8000, 90014, Oulu, Finland
2Orton Rehabilitation Centre, Tenholantie 10, 00280, Helsinki, Finland
3Department of Twin Research and Genetic Epidemiology, King’s College London, London, SE1 7EH, UK
4Department of Physical and Rehabilitation Medicine, Kuopio University Hospital, P.O. Box 1607, 70211, Kuopio, Finland
5Josip Juraj Strossmayer University of Osijek, Faculty of Medicine, Orthopaedic and Rehabilitation Hospital “Prim. dr. Martin Horvat”, Luigi Monti street n.2, 52210, Rovinj, Croatia
6Juraj Dobrila University of Pula, Department of Natural and Health Studies, Zagrebacka 30, 52100, Pula, Croatia
7Finnish Institute of Occupational Health, Aapistie 1, 90220, Oulu, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 1.3 MB)
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Language: English
Published: Springer Nature, 2018
Publish Date: 2019-11-04


Modic change (MC) is considered an independent risk factor for low back pain (LBP) but its aetiology remains unclear. In this cross-sectional, large-scale population-based study we sought to characterise associations between endplate defect (ED) and MC in a population sample of broad age range. The study population consisted of 831 twin volunteers (including 4155 discs and 8310 endplates) from TwinsUK. Lumbar T2-weighted MR images were coded for ED and MC. Total endplate (TEP) score was calculated at each intervertebral disc while receiver operating curves (ROC) were calculated to define critical endplate values predictive of MC. MC was detected in 32.1% of the subjects, with a significantly higher prevalence at lower lumbar levels (3.5% at L1/2-L3/4 vs. 15.9% at L4/5-L5/S1, p < 0.001). TEP score was strongly and independently associated with MC at each lumbar level (risk estimates from 1.49 to 2.44; all p ≤ 0.001) after adjustment for age, sex, BMI and twin pairing. ROC analysis showed a TEP score cut-off of 6 above which there was a significantly higher prevalence of MC. In conclusion, ED were strongly associated with MC at every lumbar level. These findings support the hypothesis that endplate defect is a major initiating factor for the cascade of events that may include disc degeneration (DD) and MC.

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Series: Scientific reports
ISSN: 2045-2322
ISSN-E: 2045-2322
ISSN-L: 2045-2322
Volume: 8
Article number: 16630
DOI: 10.1038/s41598-018-34933-3
Type of Publication: A1 Journal article – refereed
Field of Science: 3111 Biomedicine
3126 Surgery, anesthesiology, intensive care, radiology
Funding: This project was funded by the FP7 project Pain_omics. TwinsUK. The study was funded by the Wellcome Trust; European Community’s Seventh Framework Programme (FP7/2007–2013). The study also receives support from the National Institute for Health Research (NIHR)- funded BioResource, Clinical Research Facility and Biomedical Research Centre based at Guy’s and St Thomas’ NHS Foundation Trust in partnership with King’s College London. The department of Physical and Rehabilitation Medicine, Kuopio University Hospital, Kuopio, Finland, provided additional funding for travelling.
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