Degenerative disk disease: assessment of changes in vertebral body marrow with MR imaging.

TLDR

The study reviewed lumbar spine MR images of 474 patients and longitudinally followed 16 patients with end‑plate changes to track marrow signal evolution. Among 474 patients, 4 % had type 1 marrow changes and 16 % had type 2, with type 1 converting to type 2 in most cases while type 2 remained stable, indicating that these signal patterns represent a spectrum of marrow alterations associated with degenerative disc disease.

Abstract

The authors reviewed magnetic resonance (MR) images of 474 consecutive patients referred for lumbar spine MR imaging. Type 1 changes (decreased signal intensity on T1-weighted spin-echo images and increased signal intensity on T2-weighted images) were identified in 20 patients (4%) and type 2 (increased signal intensity on T1-weighted images and isointense or slightly increased signal intensity on T2-weighted images) in 77 patients (16%). In all cases there was evidence of associated degenerative disk disease at the level of involvement. Histopathologic sections in three cases of type 1 change demonstrated disruption and fissuring of the end plates and vascularized fibrous tissue, while in three cases of type 2 change they demonstrated yellow marrow replacement. In addition, 16 patients with end-plate changes documented with MR were studied longitudinally. Type 1 changes in five of six patients converted to a type 2 pattern in 14 months to 3 years. Type 2 changes in ten patients remained stable over a 2-3-year period. These signal intensity changes appear to reflect a spectrum of vertebral body marrow changes associated with degenerative disk disease.