Investigating a Possible Link between MRI Findings of Lumbar Disc Degeneration and Modic Changes in the Patients with Chronic Low Back Pain

Abstract

Background: In the patients with chronic low back pain (CLBP), a variety of Magnetic Resonance Imaging (MRI) abnormalities may be present that may not be necessarily associated with clinical complaints. We aim to investigate the relationship between MRI findings of lumbar disc degeneration and Modic changes in the patients with CLBP. Materials and Methods:We carried out a cross-sectional study on MRI scanning of 60 cases with CLBP. We used Pfirrmann classification and Modic changes (MC) for grading of lumbar disc degeneration and vertebral endplate signal changes, respectively. We studied these two indices in three lower lumbar intervertebral disc and adjacent endplates in cooperation with an expert radiologist and at the last, we analyzed and compared their relationships with each other.Results: Our patients had equal sex distribution and mean age of 50.8±13.6-year-old and Body Mass Index (BMI) of 27.3±4.7. MC type II was the most common change throughout lumbar region. We found a positive effect of age on disc degeneration (not MC) in all three levels. In our study, BMI had no significant effect on these two indices. There was also significant correlation between these two indices in especially two lower lumbosacral spaces. Conclusion:We found that age was a determinant factor for lumbar disc degeneration. A significant positive correlation was also found between disc degeneration and MC especially in two lower lumbosacral disc spaces. In other words, these two variables may in fact be a manifestation of a single degenerative process.