Vertebral Endplate Change as a Feature of Intervertebral Disc Degeneration: A Heritability Study

Abstract

IntroductionLow back pain (LBP) is a common disorder in the western world and accounts for disability and considerable work absenteeism.1 Lumbar disc degeneration (DD) is associated with LBP.2 It has been suggested that different DD phenotypes should be “split” rather than “lumped” into a single phenotype (DD) so as to allow a more meaningful interrogation of the pathogenic processes underlying the constituent traits.3 One trait of special interest is vertebral endplate or Modic change (MC), which comprises vertebral endplate and bone marrow lesions seen on magnetic resonance imaging (MRI).4 This trait has been found to be associated with LBP in some,5 but not all studies.6 MC is classified into three different types: types I-III. Whether MC is entirely environmental in origin, or whether it is influenced by underlying genetic factors, has not been established. Our purpose was to study (1) the prevalence of MC, (2) the progression of MC over a 10-year follow-up, and (3) the heritability of MC prevalence i...