title: Vertebral endplate changes are not associated with chronic low back pain among Southern European subjects: a case control study.
abstract: OBJECTIVE
  Data on the association between vertebral endplate changes and low back pain are contradictory. This study was designed to assess whether this association exists among Southern European subjects.
  
  
  METHODS
  Patients in this study serving as cases were 35-50 years of age with low back pain lasting >90 days, for whom a lumbar MR imaging had been prescribed. Controls were subjects 35-50 years of age, having a cranial MR imaging for headache with normal findings, and no history of clinically relevant LBP. Two hundred forty cases and 64 controls were recruited consecutively in the radiology services across 6 cities in Spain. Imaging findings and subject characteristics were gathered through previously validated instruments. Radiologists who interpreted MRI were blinded to the subject characteristics. A multivariate logistic regression model was developed to assess the association of vertebral endplate changes with LBP, adjusting for sex, age, body mass index, lifetime exposure to smoking, physical activity, disk degeneration, and the interaction between disk degeneration and vertebral endplate changes.
  
  
  RESULTS
  Vertebral endplate changes were found in 80.4% of the cases and in 87.5% of the controls. In the regression model, disk degeneration was the only variable showing a confounding effect. Results showed that after adjusting for disk degeneration, the presence of vertebral endplate changes is associated with the absence of chronic LBP (OR for LBP: 0.31; 95% CI, 0.10-0.95).
  
  
  CONCLUSIONS
  In Southern European subjects, vertebral endplate changes are not associated with chronic LBP.
authors.affiliation: Departamento Científico, Fundación Kovacs, Palma de Mallorca, Spain.
authors.forename: F M
authors.initials: FM
authors.lastname: Kovacs
authors.forename: E
authors.initials: E
authors.lastname: Arana
authors.forename: A
authors.initials: A
authors.lastname: Royuela
authors.forename: A
authors.initials: A
authors.lastname: Estremera
authors.forename: G
authors.initials: G
authors.lastname: Amengual
authors.forename: B
authors.initials: B
authors.lastname: Asenjo
authors.forename: H
authors.initials: H
authors.lastname: Sarasíbar
authors.forename: I
authors.initials: I
authors.lastname: Galarraga
authors.forename: A
authors.initials: A
authors.lastname: Alonso
authors.forename: C
authors.initials: C
authors.lastname: Casillas
authors.forename: A
authors.initials: A
authors.lastname: Muriel
authors.forename: C
authors.initials: C
authors.lastname: Martínez
authors.forename: V
authors.initials: V
authors.lastname: Abraira
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000209:etiology / Q000473:pathology*; D008159:Lumbar Vertebrae / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D013030:Spain; D011795:Surveys and Questionnaires