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Updated: Jan 21, 2026

Precision Measurements and Parametric Models of Vertebral Endplates
Published on: September 17, 2019
Relationship of endplate changes and low back pain after discectomy
Yufeng Chen1, Huilin Yang1, Yue Wang2
1Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, China.
Objectives:
Discectomy is a conventional surgery for lumbar disc herniation. However, recurrence and residual back pain are the main postoperative complications. The contribution of endplate changes to the occurrence of these complications remains controversial. This study aimed to investigate the effect of endplate changes after discectomy.
Patients And Methods:
We conducted a retrospective evaluation of 128 patients who had endplate changes after undergoing discectomy in our hospital. The patients were divided into three groups according to severity of abnormality according the Weishaupt classification (mild, moderate, and severe). The Oswestry Disability Index (ODI) and visual analog scale (VAS) were used to evaluate the efficacy of different surgical methods.
Results:
Seventeen patients dropped out of the follow-up study. Satisfactory efficacy was observed in most patients, but 16 patients underwent reoperation. Significant differences were observed among the three groups in terms of low back pain severity and ODI (p < 0.05), but not radicular leg pain severity. The severe group had a higher recurrence rate of disc herniation (23.5%) than the mild and moderate groups (10.3% and 10.4%, respectively).
Conclusion:
Discectomy had a noticeable efficacy. However, severe endplate changes, which indicated fissures on the endplate, damaged the lumbar stability and resulted in a higher recurrence rate and residual back pain. For such cases, internal fixation surgery should be considered.
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