The Coexistence Of Disc Vacuum Phenomenon And Endplate Signal Intensity Abnormalities (Modic Changes)

Objective:To investigate the coexistence of lumbar disc vacuum phenomenon and endplate signal intensity abnormities and their relationships to low back pain.Methods:A total of 176 patients (880 lumbar discs),90 male and 86 female with ages from 20 to 85(average 56.93 yrs) were enrolled in our present research with diagnosis of lumbar degenerative diseases, patients were excluded as:spinal infection, spinal metastasis, idiopathic deformities, pregnancies, spinal trauma. Their X-ray, computer tomography and magnetic resonance imaging results were downloaded and saved.One radiologist and one orthopaedics surgeon read these image independently then gave their diagnoses, any inconsistencies were resolved by discussing together. All these patients were grouped depending on the existence of disc vacuum phenomenon and Modic changes. The disc height of each was measured by using the free acquired ImageJ software.Results:Totally 143 disc vacuum phenomenon as well as 114 Modic changes were indentified.83 discs represented a coexistence of disc vacuum phenomenon and Modic changes that were more than those with single abnormalities (P<0.001); 58 (6.59%)of which represent the coexistence of disc vacuum phenomenon and ModicⅡchange, which is more than ModicⅠand ModicⅢchanges (χ2=186.835, P<0.001). The loss of disc height was significant in patients with disc vacuum phenomenon, and reached its maximum in coexistence of disc vacuum phenomenon and Modic III changes (P<0.05). Neither was age nor sexual found a correlation with disc height.(r= 0.065-0.408).Conclusions:These discs with vacuum phenomenon lost their heights extensively that may give a way to low back pain; Modic II change showed a strong correlation with disc vacuum phenomenon might explain why it usually represented a more stable pathologic stage.