SICOT e-Newsletter
Issue No. 40 - January 2012
Worldwide News
The relationship between modic change of lumbar endplate and lumbar disc herniation
HE Xian, LIANG An-jing, PENG Yan, ZHANG Xin-liang, ZHANG Liang-ming, HUANG Dong-sheng
Department of Orthopaedics,
Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University,
Guangzhou city,
Guangdong province, 510120
PR ChinaÂ
Objective: To explore the relationship between Modic change of lumbar endplate and lumbar disc herniation (LDH) and the clinical value.
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Methods: The lumbar MRI films were reviewed at L3/4, L4/5 and L5S1 levels in 628 patients (326 male and 302 female) between 14 and 85 years of age. Modic changes and the degree of LDH were evaluated. The relationship between them was analyzed. Those patients with moderate or severe LDH only in one level were divided into group A(Modic change only in this level) and group B (no Modic change in any level). The incidence and the severity of low back pain (LBP) between two groups were compared. Pain visual analogue scaleA(VAS) and Oswestry disability indexA(ODI) were used to evaluate the severity of LBP.
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Results: In 1844 discs, the incidence of Modic change in non-LDH group, mild LDH group, middle LDH group and severe LDH group were 6.83%, 23.66%, 42.72% and 50.79%, respectively, with statistically significant difference (P<0.01). Spearman correlation test showed that Modic change was related to degree of LDH (r=0.344, P<0.01). The incidence of LBP in group A and B were 59.32% and 37.97%, respectively, with statistically significant difference (P<0.01). But neither VAS score nor ODI score between the two groups was statistically significant different (P>0.05).
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Conclusion: Modic change of lumbar endplate is positively related to LDH. LDH combined with Modic change, especially type 1 change, will increase the incidence of LBP.
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Keywords: Modic change, lumbar disc herniation, low back pain