• Yunshan Su, Dong Ren, Yufeng Chen, Lindan Geng, Shuangquan Yao, Haotian Wu, and Pengcheng Wang.
• Orthopaedic Trauma Service Center, Major Laboratory of Orthopaedic Biomechanics in Hebei Province, The Third Hospital of Hebei Medical University, Shijiazhuang, 050051, Hebei Province, China.
• Eur Spine J. 2023 Jan 1; 32 (1): 556755-67.

ObjectiveTo determine the effect of endplate reduction on the final healing morphology and degenerative changes in intervertebral discs.MethodsForty-eight patients with single-level thoracolumbar fractures with endplate injury were included. All patients underwent posterior reduction and pedicle screw fixation, and postoperative imaging was used to determine whether endplate reduction was successful. The healing morphology of the endplate was divided into three types: increased endplate curvature, irregular healing and traumatic Schmorl node. MRI was performed at baseline and at the last follow-up evaluation to observe changes in disc degeneration (disc height and nucleus pulposus signal) and Modic changes.ResultsThe reduction rate in the central area was significantly lower than that in the peripheral area (P = 0.017). In patients with successful reduction, 90.9% (20/22) of the endplates healed with increased curvature. In patients with an unsuccessful endplate reduction, 63.4% (26/41) of the endplates healed irregularly, and 34.1% (14/41) of the endplates formed traumatic Schmorl nodes. Endplate reduction was closely related to the final healing morphology of the endplate (P < 0.001), which had a significant protective effect on the degeneration of the intervertebral disc. At the last follow-up evaluation, there was no statistically significant correlation between different endplate healing morphologies and new Modic changes.ConclusionsThe reduction rate in the central area is significantly lower than that in the peripheral area. Although all of the intervertebral discs corresponding to fractured endplates had degenerated to different degrees, successful endplate fracture reduction can obviously delay the degeneration of intervertebral discs.© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

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