Analysis of the relationship between Modic change and spinopelvic alignment parameters in degenerative scoliosis patients

Abstract

Background: Sagittal alignment and coronal balance have been considered to be important in treating patients with degenerative scoliosis (DS). Previous studies have reported that Modic changes (MCs), disc degeneration (DD),and facet tropism(FT) have been considered as major factors forspinopelvic alignment parameters inpatients with DS. However, no previous study has investigated relationship between them.Methods: Our retrospective study recruited 38 DS patients and41 healthy age and sex matched individuals.The DS patientswere divided into DS group andhealthy age and sex matched individuals were divided into healthy group.Full‑length frontal and lateral views of the entire spine was measured to evaluate sagittal alignment and coronal balance. Endplate-disc-facetjoints degeneration of patients with DS were quantified using the Modic classifications, DD, and FT.The spinopelvic alignment parameters were measured, including pelvic incidence,sacral slope,lumbar lordosis, thoracic kyphosis, C7-sagittal vertical axis, L3 tilt, coronal balance distance, coronal cobb angel, thoracolumbar junctional angle, T1 pelvic angle.Results:Based on radiographic findings, the incidence of MCs at different lumbar level was higher percentage of participants showed MCsand FT in the DS group (DS group: 52.63%, healthy group: 11.24%). The coronal and sagittal parameters were significantly different between DS group and healthy group (p<0.05), except for SS (>0.05).Besides, there was significant correlation between the coronal and sagittal parameters.Conclusions: Coronal deformity has little effect on sagittal parameter sexcept for SVA, TK, and LLI. Besides, differentcoronal deformity types show weak difference on sagittal plan. The prevalence of MC in DLS group is higher than healthy group, which result in poorer clinical outcomes.