Study of the Distribution of Lumbar Modic Changes in Patients with Low Back Pain and Correlation with Lumbar Degeneration Diseases

Baixing Wei, Han Wu Department of Orthopedics, China-Japan Union Hospital of Jilin University, Changchun, Jilin, People’s Republic of ChinaCorrespondence: Han Wu, Department of Orthopedics, China-Japan Union Hospital of Jilin University, No. 126 Xi’antai Avenue, Changchun, Jilin, People’s Republic of China, Tel +86 43189876902, Email wu_han@jlu.edu.cnPurpose: To study the distribution of lumbar Modic changes (MC) in low back pain patients, and to explore the relationship between Modic changes and age, gender, segment and lumbar degeneration diseases (disc degeneration, spinal stenosis, lumbar spondylolisthesis).Patients and Methods: Modic changes were counted and analysed in 500 randomly selected patients who visited the outpatient clinic for lumbar spine MRI for low back pain from 2019 to 2022. The relationship between Modic changes and bulging disc, protrusion, extrusion, sequestration, Schmorl’s node, spinal stenosis, and lumbar spondylolisthesis was studied. Data correlations were compared using the chi-square test, P< 0.05 was considered a statistically significant difference.Results: Modic changes were present in 184 segments. 58 were type I, 119 were type II, and 7 were type III. The number of Modic changes segments in L1-2, L2-3, L3-4, L4-5, and L5-S1 was 10, 22, 22, 58, and 72, respectively. Modic changes by gender occurred in 44 males and 82 females, and by age grouping were 0 cases in 10– 19 years, 3 cases in 20– 29 years, 6 cases in 30– 39 years, 41 cases in 40– 49 years, 64 cases in 50– 59 years, 38 cases in 60– 69 years, 15 cases in 70– 79 years, and 5 cases in 80– 89 years, respectively. Modic changes occurred in 56 with bulging disc, 45 with Protrusion, 57 with Extrusion and Sequestration, 32 with Schmorl’s node, 32 with spondylolisthesis, and 56 with stenosis. Modic changes correlated with all of the above factors except bulging disc, and all differences were statistically significant (P< 0.05).Conclusion: The most common type of Modic changes is type II; Modic changes have correlation with age, gender, segment, lumbar disc herniation, lumbar spondylolisthesis, and lumbar spinal stenosis, and are a very important factor in low back pain.Keywords: low back pain, Modic changes, disc degeneration, spinal stenosis, lumbar spondylolisthesis