Patients with Modic type 2 change have a severe radiographic representation in the process of lumbar degeneration: a retrospective imaging study

Abstract

Background There are few studies to investigate changes in imaging parameters of Modic changes (MCs). The imaging studies examining the distinctions in the lumbar sagittal parameters between MCs and lumbar disc degeneration (LDD) are still lacking. The purpose of this study was to identify the differences in the lumbar sagittal parameters among patients for LDD with/without Modic type 2 change (MII). Methods A total of 208 patients with lumbar degenerative disease from January 2017 to August 2018 volunteered for this study. Sixty-two patients with MII were used as the MC group. The other 146 patients served as the disc degeneration (DD) group. The DD scores and sagittal parameters were measured on magnetic resonance imaging (MRI) and X-ray by using Surgimap software. Results The prevalence of MII for patients with degenerative lumbar diseases in this study was 29.81%, primarily located at L5/S1. There were significant differences in lumbar lordosis (LL) and sacral slope (SS) between these two groups ( P < 0.05). Similarly, the significant decrease in intervertebral height index (IHI) was found at L3-S1 in the MC group, compared with the DD group ( P < 0.05). However, a significant difference in intervertebral angle (IVA) was observed only at L5/S1 ( P < 0.05). The MC group had the smaller endplate concave angle (ECA) than the DD group from L3 caudal endplate to S1 cranial endplate ( P < 0.05). Conclusions MII has a severe radiographic representation in the process of lumbar degeneration than patients without MII, and the overconcentration of load caused by the smaller LL, SS, and IVA may be a reasonable explanation to answer why MCs are more common at the L5/S1.

The Immune Privilege of the Intervertebral Disc: Implications for Intervertebral Disc Degeneration Treatment

“…Also, type 1 Modic change, which is widely observed in early IVD degeneration, is thought to be an autoimmune response with CEP damage [54]. Indeed, these image manifestations are strong evidence for IVD degeneration prognostication and early management [55][56][57]. Additionally, studies have found that inflammatory factors are upregulated in serum from IVD herniation patients.…”

Non-surgical therapy for the treatment of chronic low back pain in patients with Modic changes: A systematic review of the literature

“…[ 13 , 14 ] in 1988. It, coupled with their more severe radiographic performance than simple disc degeneration [ 15 , 16 ] and positive correlation with CLBP [ 17 ], has also been attracted widespread academic attention. Although a recent paper from the Wakahama Spine Study [ 17 ], have reported a positive association between MCs and LBP, the most recent systematic review on this topic [ 18 ] concludes that the associations between MCs and LBP-related outcomes are inconsistent.…”

Comparison of Percutaneous Transforaminal Endoscopic Decompression and Transforaminal Lumbar Interbody Fusion in the Treatment of Single-Level Lumbar Disc Herniation with Modic Type I Changes

“… 3 Although the etiology of MC is still unclear, 4 microfracture of the endplate is thought to be a key link in MC formation. 5 As the cartilage endplate of the vertebral body changes, the herniated disc associated with degenerative disc disease will also change. 2 Among the different MC types, MC I is often considered to have a high correlation with clinical symptoms.…”