Analysis Of Modic Change And Schmorl’s Node With Spinopelvic Sagittal Parameters And Lumbar Disc Degeneration

Objectives:A retrospective study to analysis the relationship between Modic change(MC)and Schmorl’s node(SN)with spine-pelvic sagittal parameters and lumbar disc degeneration(LDD).Methods:Retrospective analysis was conducted on the patient whit lumbar degeneration disease(mainly include lumbar disc herniation,lumbar spinal stenosis,lumbar degenerative spondylolisthesis)admitted to the spinal surgery department of our hospital from July 2018 to December 2018.Record and analyze the demographic data of the patients.Spine-pelvic sagittal parameters were measured on the anteroposterior and lateral radiographs of lumbar spine.The prevalence of MC and SN were assessed on sagittal T1,T2-weighted magnetic resonance images(MRIs)and the degree of intervertebral disc degeneration from L1 to L5 were evaluated by Pfirrmann grading system.All parameters grouped and analyzed according to MC or SN occurs or not.Moreover,PT was also compared in the different type of MC.The difference between MC&SN and control group was also compared.Finally,the relationship between MC or SN whit lumbar disc degeneration was analyzed and compared the difference of degenerative grade in each discs.Result:1、There 300 patients(157 males and 143 female)included in this study.The mean age of male and female patients are 53.34±14.45 and 56.06±12.02.The prevalence of MC was 48.6%(146/300),with the highest incidence of L4/5 and L5/S1(19% and 26.7%,respectively),showing statistically significant differences compared with other segments.The incidence of SN is 35.7%(107/300),According to our research,we found SN has the lowest incidence in L5/S1(6.9%),which is statistically significant compared with the incidence of other disc level.2、Compared with MC(-)group,age(P=0.026)and PT(P=0.005)are much higher in MC(+)group.Except age(P<0.01)is higher in SN(+)group,others parameters are no difference between two groups.3、When analysis the relationship between MC and intervertebral disc degeneration we found MC is closely related to degeneration of L4/5and L5/S1(OR=1.252、1.412).However,SN only related to L1/2、L2/3 及 L3/4(OR=4.85、5.407 and 10.029)and there grade.Conclusions:1、 MC mostly occurs in L4/5 and L5/S1 segments,and usually occurs in pairs,while SN has the lowest incidence in L5/S1 segment。2、Among all pelvic parameter,only PT related to MC.There is no spinal-pelvic parameters related to SN。3、MC is closely related to the degeneration and grade of L4/5 and L5/S1。4、SN is closely related to the degeneration and grade of L1/2、L2/3 and L3/4。5、Preoperative assessment of the patient’s MC,SN and spinal pelvic parameters is helpful for clinical diagnosis and treatment.