<b>Diagnostic Role of Magnetic Resonance Imaging in Low Back Pain Caused by Vertebral Endplate Degeneration</b>

Background: Low back pain is a major cause of disability, and vertebral endplate degeneration is increasingly recognized as an important structural contributor to chronic lumbar symptoms. MRI allows detailed visualization of disc degeneration, vertebral endplate irregularities, Modic changes, and marrow signal alterations. Objective: To evaluate the diagnostic role of MRI in detecting vertebral endplate degeneration and associated lumbar spine abnormalities among patients with low back pain. Methods: This descriptive cross-sectional study was conducted at Lahore General Hospital among 90 patients presenting with low back pain and referred for lumbar spine MRI. Clinical data were collected using a structured form, pain was assessed using the Visual Analogue Scale, and disability was assessed using the Oswestry Disability Index. MRI evaluation included T1-weighted, T2-weighted, and STIR sequences. Data were analyzed using SPSS version 25. Results: Disc degeneration was identified in 62 patients, disc herniation in 54 patients, and endplate irregularities in 38 patients. Modic changes showed a statistically significant association with gender in the available cross-tabulated data (χ²=18.489, p<0.001). MRI demonstrated sensitivity of 91.2%, specificity of 78.6%, positive predictive value of 89.7%, negative predictive value of 81.5%, and overall accuracy of 87.1%. Conclusion: MRI is a clinically useful modality for detecting vertebral endplate degeneration and associated lumbar degenerative abnormalities in patients with low back pain