Table of ContentsView AllTable of ContentsAnatomyFunctionCausesDiagnosisTreatment
Table of ContentsView All
View All
Table of Contents
Anatomy
Function
Causes
Diagnosis
Treatment
Vertebral endplates are located betweenvertebrae(bones of the spine) and intervertebral discs (the gel-filled structures that protect and cushion the vertebrae). They consist of a layer ofcartilageand a layer of porous bone.
Vertebral endplates serve as a layer of protection between the hard, bony vertebrae and the softer, more delicate discs. They also are the passageway through which blood and nutrients make their way to the discs. The injury or degeneration of the endplates in thelumbar (lower) spinemay cause certain types of back pain.
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Anatomy of Vertebral Endplates
Each vertebral endplate consists of two distinct layers:
The diameter and shape of each endplate correspond to the diameter and shape of the vertebra it is attached to. Endplates in thecervical (neck) spinewill be smaller, while endplates in the lumbar spine will be larger.
In young adults, vertebral endplates are dense, thick, and curved. Over time, they become thinner, flatter, and more brittle due to the stress of gravity and your body weight,
Function of Vertebral Endplates
The lower vertebrae of the spine take on the weight of the upper body and are therefore subject to considerable stress.
As the intermediary layer between the bones and discs, the vertebral endplates provide strength and stability to help prevent fractures and protect the delicate intervertebral discs.
Because of their porousness, they also serve as the vehicle through which blood and nutrients flow from capillaries in the bone to cells in the discs.This is important because intervertebral discs do not receive their own blood supply as the vertebrae do.
Studies have found that the development of lesions on endplates in the lumbar spine is associated with increasing levels of low back pain. In its advanced stages, endplate degeneration is calledendplate sclerosis(sclerosis meaning “hardening”).
There are two common conditions associated with vertebral endplate failure and the onset of endplate sclerosis:
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Endplate damage can be difficult to detect, even with diagnostic imaging. For this reason, healthcare providers often overlook this when investigating the cause of low back pain.
When a healthcare provider detects Modic changes, they may be able to identify a link between these changes and certain types of low back pain.
The degeneration of the vertebrae of the spine—in particular, endplate damage—should be treated in a progressive fashion, starting with less invasive interventions and moving up to more invasive alternatives if initial treatments don’t give the desired results.
Physical Therapy
It is no surprise that physical therapy is one of the few interventions that has shown benefits in treating chronic back pain. Improving back functionality is key in order to overcoming the pain and limitations that come from endplate degeneration.
A thorough course of physical therapy must be the first step on the road to recovery from the pain associated with vertebral endplate failure.
Weight Loss
Ultimately this is an issue of gravity: The spine is in charge of receiving our body weight. And people who are overweight will have faster and more profound degeneration of their vertebral endplates. It is never too late to try and lose weight.
Marginal weight losses of 5% to 10% of body weight can have a dramatic impact on the pain that stems from vertebral endplate failure.
Medications
Taking medications like Tylenol (acetaminophen) ornonsteroidal anti-inflammatory drugs (NSAIDs)such as Advil (ibuprofen) on schedule—with the guidance of a doctor—can be useful for issues like chronic back pain.
Other medications for chronic pain for this type of ailment include:
Surgery
When endplate degeneration advances to the point of causing severe pain and debilitation, treatment typically involves lumbar spinal fusion surgery.
This procedure involves stimulating the growth of new bone between two vertebrae. Sometimes the disc between them as well as the endplate are removed to allow the vertebrae to fuse.
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5 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Lotz JC, Fields AJ, Liebenberg EC.The role of the vertebral end plate in low back pain.Global Spine J. 2013; 3(3):153–164. doi:10.1055/s-0033-1347298Sahoo MM, Mahapatra SK, Kaur S, Sarangi J, Mohapatra M.Significance of vertebral endplate failure in symptomatic lumbar disc herniation.Global Spine J.2017 May;7(3):230–8. doi:10.1177/2192568217694142Bowden JA, Bowden AE, Wang H, Hager RL, Lecheminant JD, Mitchell UH.In vivo correlates between daily physical activity and intervertebral disc health.J Orthop Res. 2018;36(5):1313-23. doi:10.1002/jor.23765Chen Y, Yang H, Zhang L, et al.Analyzing the influence of Modic changes on patients with lower back pain undergoing conservative treatment.Pain Res Manag. 2019;2019:8185316. doi:10.1155/2019/8185316Peng B, Chen J, Kuang Z, et al.Diagnosis and surgical treatment of back pain originating from endplate.Eur Spin J. 2019;(18)1035–1040. doi:10.1007/s00586-009-0938-4
5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Lotz JC, Fields AJ, Liebenberg EC.The role of the vertebral end plate in low back pain.Global Spine J. 2013; 3(3):153–164. doi:10.1055/s-0033-1347298Sahoo MM, Mahapatra SK, Kaur S, Sarangi J, Mohapatra M.Significance of vertebral endplate failure in symptomatic lumbar disc herniation.Global Spine J.2017 May;7(3):230–8. doi:10.1177/2192568217694142Bowden JA, Bowden AE, Wang H, Hager RL, Lecheminant JD, Mitchell UH.In vivo correlates between daily physical activity and intervertebral disc health.J Orthop Res. 2018;36(5):1313-23. doi:10.1002/jor.23765Chen Y, Yang H, Zhang L, et al.Analyzing the influence of Modic changes on patients with lower back pain undergoing conservative treatment.Pain Res Manag. 2019;2019:8185316. doi:10.1155/2019/8185316Peng B, Chen J, Kuang Z, et al.Diagnosis and surgical treatment of back pain originating from endplate.Eur Spin J. 2019;(18)1035–1040. doi:10.1007/s00586-009-0938-4
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Lotz JC, Fields AJ, Liebenberg EC.The role of the vertebral end plate in low back pain.Global Spine J. 2013; 3(3):153–164. doi:10.1055/s-0033-1347298Sahoo MM, Mahapatra SK, Kaur S, Sarangi J, Mohapatra M.Significance of vertebral endplate failure in symptomatic lumbar disc herniation.Global Spine J.2017 May;7(3):230–8. doi:10.1177/2192568217694142Bowden JA, Bowden AE, Wang H, Hager RL, Lecheminant JD, Mitchell UH.In vivo correlates between daily physical activity and intervertebral disc health.J Orthop Res. 2018;36(5):1313-23. doi:10.1002/jor.23765Chen Y, Yang H, Zhang L, et al.Analyzing the influence of Modic changes on patients with lower back pain undergoing conservative treatment.Pain Res Manag. 2019;2019:8185316. doi:10.1155/2019/8185316Peng B, Chen J, Kuang Z, et al.Diagnosis and surgical treatment of back pain originating from endplate.Eur Spin J. 2019;(18)1035–1040. doi:10.1007/s00586-009-0938-4
Lotz JC, Fields AJ, Liebenberg EC.The role of the vertebral end plate in low back pain.Global Spine J. 2013; 3(3):153–164. doi:10.1055/s-0033-1347298
Sahoo MM, Mahapatra SK, Kaur S, Sarangi J, Mohapatra M.Significance of vertebral endplate failure in symptomatic lumbar disc herniation.Global Spine J.2017 May;7(3):230–8. doi:10.1177/2192568217694142
Bowden JA, Bowden AE, Wang H, Hager RL, Lecheminant JD, Mitchell UH.In vivo correlates between daily physical activity and intervertebral disc health.J Orthop Res. 2018;36(5):1313-23. doi:10.1002/jor.23765
Chen Y, Yang H, Zhang L, et al.Analyzing the influence of Modic changes on patients with lower back pain undergoing conservative treatment.Pain Res Manag. 2019;2019:8185316. doi:10.1155/2019/8185316
Peng B, Chen J, Kuang Z, et al.Diagnosis and surgical treatment of back pain originating from endplate.Eur Spin J. 2019;(18)1035–1040. doi:10.1007/s00586-009-0938-4
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