Relationship between type of lumbar vertebra modic changes with disc herniation and degenerative changes of the lumbar spine

Abstract

Degenerative disc changes are commonly seen in the lumbar spine. Although disc degeneration is a common finding, epidemiological studies have used various measurements to define the disease. Nowadays, MRI is widely used to investigate the cause of low back pain and changes in the signal of the vertebral end plate (modic) have been accepted as one of the parameters of degenerative changes in the vertebrae. Recent studies have shown that signal changes in the end plate of the vertebrae and bone marrow are closely related to back pain.

Materials & Method: In this cross-sectional study, 163 patients with low back pain who referred to Imam Reza Hospital in Tabriz for MRI were included in the study. Imaging was performed by MRI in four sections of sagittal T1 & T2, T2 Axial and STIR sagittal. Patients' images were classified according to bone marrow changes in the end plates of the vertebrae (modic system). Degenerative changes were graded based on the Pfirrman system. Degenerative changes of the posterior elements, including hypertrophic ligament hypertrophy (greater than 3 mm) and fast joint arthropathy, were also examined.

Results: In general, in this study, 163 patients with chronic low back pain with involvement of the end plates of the disc (modic) were included in the study for one year, of which 53 patients (32.5%) were male and 110 patients (67.5%) were female. There was no significant relationship between modic changes and disc degeneration .The most common type of disc herniation was bulging with 44.2% and the most common hernias occurred at L5-S1 and L4-L5 levels (P <0.01). There was a significant relationship between hypertophy of ligamentum flavum and facet hypertrophy and the severity of disc degeneration. (p <0.02)