Abstract
BackgroundThere 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).MethodsA 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.ResultsThe 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).ConclusionsMII 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.
Highlights
The endplates between vertebral bone and intervertebral disc are the important elements in the structures of the lumbar spine, which are composed of thin hyaline cartilage with an average thickness of 0.6 mm [1, 2]
Patient demographics and prevalence of Modic changes (MCs) We reviewed the MR images of 208 patients. 29.81% (62/208) of patients with Modic type 2 (MII) on the basis of lumbar disc degeneration (LDD) were used as the MC group
The overconcentration of load caused by the smaller lumbar lordosis (LL), sacral slope (SS), and intervertebral angle (IVA) may be a reasonable explanation to answer why MCs are more common at the L5/S1
Summary
The endplates between vertebral bone and intervertebral disc are the important elements in the structures of the lumbar spine, which are composed of thin hyaline cartilage with an average thickness of 0.6 mm [1, 2]. Modic changes (MCs) have been considered as an important feature of spinal degeneration on MRI. The microfracture of endplate caused by degenerative spinal structure [7] and repetitive “fatigue” loading [8] is the key link of MCs. Besides, endplate and intervertebral disc damage caused by biomechanical imbalances can provide. 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)
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