Analysis Of The Correlation Between Modic Changes And Osteoporosis And Low Back Pain

[Objective] The purpose of this study was to study the correlation between vertebral bone mineral density and Modic changes on lumbar MRI in patients over 50 years old with low back pain,and to explore the significance of vertebral bone mineral density in Modic changes.[Methods] From September 2018 to September 20,152 patients with low back pain underwent vertebral bone mineral density measurement and lumbar MRI examination in the Department of Spinal surgery of the first affiliated Hospital of Bengbu Medical College.the vertebral bone mass was measured and the imaging data were observed.According to the level of bone mass,all patients were divided into normal bone mass group(n = 89),osteopenia group(n = 43)and osteoporosis group(n = 20).The incidence of Modic changes in the three groups was compared,and the relationship between vertebral bone mineral density and Modic changes was analyzed.The degree of low back pain was scored by pain visual simulation(VAS),and the relationship between Modic changes and osteoporosis and low back pain was analyzed.[Results] Among the 152 patients,there were 89 cases of normal bone mass and29 cases of Modic changes(12 cases of type I,15 cases of type II,2 cases of type III),with an incidence of 32.6%.There were 43 cases of osteopenia and 23 cases of Modic changes(10 cases of type I,12 cases of type II,1 case of type III),with an incidence of53.5%.There were 20 cases of osteoporosis and 17 cases of Modic changes(5 cases of type I,8 cases of type II,4 cases of type III),with an incidence of 85.0%.There was significant difference in the incidence of Modic changes among the three groups(X219.685 P < 0.05).Spearman rank correlation test showed that there was a weak positive correlation between osteoporosis and Modic changes(r = 0.396,P < 0.01).There was significant difference in the change rate of Modic between osteoporosis and osteopenia group and normal bone mass group(X2: 5.306,18.394,P < 0.01),and between osteopenia and osteoporosis group,and between osteoporosis group and osteoporosis group(X2: 5.848,P < 0.05),and between osteoporosis group and osteoporosis group,there was significant difference in Modic change rate between osteoporosis group and osteoporosis group.The incidence of Modic change in osteopenia group and osteoporosis group was higher than that in normal bone mass group,and the VAS score of type I group was the highest compared with Modic type II and type III.There was significant difference in the degree of low back pain between Modic type I group and no Modic change group,type II and III group(P < 0.05).[Conclusion] In the elderly over 50 years old,there was a correlation between vertebral bone mineral density and Modic changes,and the incidence of Modic changes increased with the decrease of vertebral bone mineral density.Modic type I changes were closely related to low back pain.