The Distribution Of Modic Changes Of Lumbar Endplate In Patients Suffering From Low Back Pain Or Radiculopathy And Its Related Factors

Objectives:To evaluate the distribution of Modic changes of lumbar endplate in patients suffering from low back pain or radiculopathy and its related factors.Methods:1040 patients in ward or out-patient department suffering from low back pain or sciatica were examined by lumbar MR scan and conventional X-ray examination from March 2007 to March 2008.According to the cirteria of Modic changes,the features of distribution of Modic changes of lumbar endplate on segment, sex,age, and body mass index were analyzed retrospectively.All imaging data were diagnosed by a radiologist and an orthopedist according to independent double-blind principle, and the accqured results were checked by two Kappa consistency . The incidences of Modic changes in sex, age, body mass index were tested by X2 comparison using SPSS package version 13.0,and P <0.05 were identified as statistically significant.Results:Among 5200 intervertebral disc of the 1040 patients,368(35.4%) cases and 448(8.6%)intervertebral discs were involved with Modic changes.Among them,58(5.6%)cases and 59(1.1%)discs were type I;307(29.5%)cases and 386(7.4%)discs were type II;3 (0.3%)cases and 3(0.06%) discs were type III.According to the segment,L5-Sl:237(22.8% ) ,L4-5:155(14.9 % ),L3-4:40(3.8 % ) ,L2-3:15(1.4 % ) , L1-2:1(0.1%).Modic changes occurred more often in the L5-Sl and L4-5 segments. 40.8% (200/490) female cases verse 29.5%(168/550) male cases in Modic change which means Modic changes distirbuted more often in female than in male (P < 0.05). According to age,the incidence of Modic changes in 20 to 29 age group was 10.5%, 30 to 39 age group was 12.5%, 40 to 49 age group was 37.2 %, 50 to 59 age group was 38.0%, 60 to 69 age group was 40.0%, 70 to 79 age group was 47.6%, and 80 to 89 age group was 38.5%.Modic changes distirbuted mainly over the age of 40 years. The incidence of Modic change was 31.3 percent in the normal body weight group,was 34.7 percent in over-weight group, and was 44.5% in the obese group, There is no significant differenc between the normal group and over-weight group. There was significant difference between the normal group and obesity group(P <0.05). There was significant differences between over-weight group and obesity group(P<0.05). Modic changes distirbuted more often in obesity group.Conclusion:Modic change of lumbar endplate was more often seen in patients suffering low back pain or radiculopathy. The changes of lumbar endplate mainly occured in L5-S1 and L4-5 segment, and type II was the most , mainly happened in female and over 40 years old. Modic changes distirbuted more often in obesity group.