Distribution Patterns Of Modic Changes And Correlative Factors Of Modic Changes In Low Back Pain Patients

Objective To investigate the distribution pattern of Modic changes in patients with low back pain and addressed the potential determinants and the association of Modic changes.Methods Lumbar MRI and clinical data of 829 patients with low back pain(LBP)in our hospital from December2016 to December 2018(research group)and 198 subjects without clinical history of LBP at the same period(control group)were analyzed retrospectively.The distribution features of Modic changes were recorded,and correlative factors were analyzed.Results 1.829 patients and 4145 lumbar intervertebral discs in research group,478 patients(57.66%)and 802 intervertebral discs(19.35%)with adjacent endplate's Modic changes were observed.In control group including 198 patients and 990 lumbar intervertebral discs,Modic changes could be detected in 78 patients(39.39%)and in 100 intervertebral discs(10.10%)with adjacent endplate.The difference was statistically significant(P<0.05).2.In research group(n=829),there were 478 patients with Modic changes:43 cases with the age of 16 to 39 years(24.57%),274cases with the age of 40 to 5 years(60.31%),and 161 cases aged 60 years and over(81.31%),and statistical significance was attained;there were 397 males and 492 females,and the incidence of Modic changes in female(n=266,61.57%)was higher than in male(n=212,53.40%),but no statistical significance was attained(?~2=0.04,P=0.45>0.05);the prevalence rate of Modic changes of underweight or normal patients(n=308,56.72%),overweight patients(n=116,63.04%)and obese patients(n=54,52.94%)showed no statistical difference(P>0.05);the incidence of Modic changes at the low lumbar spine was significantly higher than that at the superior lumbar spine(?~2=374,P=0.00<0.05).3.In research group,Spearman correlation test showed that,except for L1/2 and L4/5?L5/S1 as well as L3/4 and L5/S1,Modic changes were positively correlated with the degree of lumbar degeneration(DDD)(P<0.05).4.In research group,the results of Spearman correlation test showed that there was no correlation between Modic changes and high intensity zone(HIZ).Conclusion 1.The incidence of Modic changes in lumbar has significant difference between the research group and control group.Modic changes in lumbar spine are associated with LBP.2.Modic changes in patients with LBP are more common in the elderly,mainly in the low lumbar spine.2.Modic changes in patients with low back pain are more common in the elderly,mainly in the low lumbar spine.3.In patients with LBP,Modic changes are associated with year and DDD,especially show a significant positive correlation with DDD except for some segments,such as L1/2 and L4/5?L5/S1as well as L3/4 and L5/S1.To a certain extent,Modic changes can indicate severe lumbar disc degeneration.The occurrence of Modic changes in patients with LBP is related to age,but not gender,weight and HIZ.