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Vertebral endplate defects: nomenclature, classification and measurement methods: a scoping review

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Abstract

Purpose

To summarize the scope of nomenclature and measurement methods used to document endplate defects in the health sciences literature.

Methods

The scoping review followed the York framework and was reported according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews. The databases of PubMed, Scopus, Embase and CINAHL were searched using key terms. Screening and selection were conducted by two independent reviewers. A standardized, pilot-tested form was used for extracting data, which were analyzed descriptively.

Results

The review included 211 studies, originating from 29 countries, with the USA (18.8%) and China (12.26%) as leading contributors. Thirty-four different terms for structural endplate defects were reported, but were never defined in most studies (65%). Of the 34 different terms used, some appeared to represent the same phenomenon, while the same terms were occasionally defined differently between studies. Schmorl’s nodes were most commonly investigated (n = 99 studies) and defined similarly across studies, with the main difference relating to whether the indentation (node) was required to have a sclerotic margin. There were also similarities in definitions for endplate sclerosis. However, there was great variability in the definitions of other terms, such as lesions, irregularities, abnormalities, erosions and changes.

Conclusion

With the possible exception of Schmorl’s nodes, we lack a common language for effectively communicating structural endplate findings. This review provides a foundation and impetus for standardizing terminology and core measures to improve communication and synthesis of the growing body of endplate research to advance related knowledge.

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Acknowledgements

The authors thank Dianne Bryant for her review and critical comments, which improved the manuscript, Zakari Crites Videman for his assistance in the article selection and inclusion process and Meagan Stanley for her assistance towards developing the search strategy.

Funding

No specific funding was received for this project. However, Aliyu Lawan, as a graduate student, receives support from the Faculty of Health Sciences and a Transdisciplinary Training Award from the Bone and Joint Institute at Western University.

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Authors and Affiliations

  1. Faculty of Health and Rehabilitation Sciences, and Western’s Bone and Joint Institute, Elborn College, Room 1445, Western University, London, ON, N6G 1H1, Canada

    Aliyu Lawan & Michele C. Battié

  2. Department of Medical Imaging, Victoria Hospital, London Health Sciences Centre, Room C1-649, 800 Commissioners Road East, London, ON, N6A 5W9, Canada

    Andrew Leung

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Correspondence to Michele C. Battié.

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Lawan, A., Leung, A. & Battié, M.C. Vertebral endplate defects: nomenclature, classification and measurement methods: a scoping review. Eur Spine J 29, 1397–1409 (2020). https://doi.org/10.1007/s00586-020-06378-8

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