Analysis of the relationship between Modic changes and sagittal parameters in the lumbar spine

Jianjun Liu¹, Junjie Yin², DaSheng Tian¹, Lei Chen¹, Bin Zhu¹, Juehua Jing^{1, *}

¹Department of Orthopedics, the second Hospital of Anhui Medical University - ²Department of Nursing, the second Hospital of Anhui Medical University

Introduction: Modic change is believed to be associated with rapidly advancing spinal degeneration. Studies evaluating the association between Modic change and sagittal alignment of the lumbar spine are limited. This study aimed to investigate the relationship between Modic changes and lumbar spine sagittal parameters.

Materials and methods: We conducted a retrospective study with 138 patients who underwent radiographic and magnetic resonance imaging (MRI) of the lumbar spine. Sagittal parameters were measured on the radiographs, including the lumbosacral intervertebral disk angle, lumbar lordosis, anterior angle of the lumbar spine, and lumbosacral joint angle. The Modic changes were identified using MRI. The patients were divided into Modic change (+) and Modic change (−) groups according to the presence or absence of Modic changes, respectively. The relationship between Modic changes and all the parameters were analysed using a t test and logistic regression analysis. The parameters were compared between the Modic change (+) and (−) groups.

Results: We found that the incidence of lumbar lordosis was significantly lower in the Modic change (+) group than in the Modic change (−) group (P < 0.05). The multivariate logistic regression analysis results showed that lumbar lordosis was an independent risk factor of Modic changes. However, no significant differences in the other parameters were found between the two groups. Modic change was most frequent at the L5S1 level, followed by the L4–5 level.

Conclusion: Our study demonstrated that lumbar lordosis could be a risk factor for the development of Modic changes due to impaired biomechanics, especially in the L5S1 lumbar segment.