Preliminary Study Of The Distribution And Related Factors Of Modic Changes In The Patients With Low Back Pain

Objective: To evaluate the distribution of Modic changes of lumbarendplate in patients suffering from low back pain and to investigatethe correlation between Modic changes and age, gender, segment, otherpathological changes such as disc degeneration, spinal stenosis,spondylolisthesis, etc.Methods:452patients in ward suffering from low back pain or/andsciatica pain who were examined by lumbar MRI scan and conventionalX-ray examination from January2009to January2010were included inthe study, the criteria of Modic changes, located segments, gender, ageand coexisted pathologic changes of the spine such as disc bulging, discherniation, disc prolapse, schmorl nodes, spinal stenosis,spondylolisthesis were analyzed respectively. The data were tested byX2comparison, and P<0．05were identified as statistically significant．Results: Among2260disc segments of452patients,312segments(13.8%) of185patients (40.9%) were involved with Modic changes, amongwhich68(22.7%) segments of55patients were typeⅠ，208(65.6%) segmentsof140patients were type Ⅱ, and23(7.7%) segments of23patients weretype Ⅲ, type Ⅰ is the most common type of Modic changes, while typeⅢ is the least, mean while, the mixed Modic changes of three types werefound in one segment. The involving segments from L1-2to L5S1were20(6.4%),49(15.7%),58(18.6%),84(26.9%),101(35.3%) respectively.There was significant differences between each group (P<0.005).73(35.3%) cases were found in male patients while112(45.7%) cases in female, there was no difference between these two groups. Analysed byage, The incidence of Modic changes found in10-19group was0patients(0%),20-29group was1patient(12.5%),30-39group4patients(10.0%),40-49group43patients(41.0%),50-59group64patients(47.8%),60-69group47patients(47.5%),70-79group22patients(44.9%) and80-89group4patients(33.3%). Modic changes wasmost commonly found in patients over40years old. Modic changescoexisted with disc bulging, disc herniation, disc prolapse, schmorlnodes, spinal stenosis, spondylolisthesis were68segments(16.6%),74segments(10.6%),75segments(31.5%),150segments(13.2%),14segments(12.2%) and20segments(28.2%) respectively, correlations werefound between Modic changes and the pathological changes of discprolapse and spondylolisthesis.Conclusion: There was relevance between Modic changes and low backpain; Type Ⅱ is the most common type of Modic changes, while type Ⅲis the least; Relevance between Modic changes and segments exists, therewere gradually increased incidence of Modic changes as the segments getlower; Modic changes mainly involve people over40years old; Modicchanges has a high incidence in patients with spondylolisthesis and hadrelationship to it; so it is with the patients has the prolapse typeof lumbar disc herniation.