Distribution and associated factors of endplate Modic changes in degenerative lumbar scoliosis

Objective:To investigate the distribution of endplate Modic changes in degenerative lumbar scoliosis,and the associated factors with low back pain.Method:The imaging data of 126 patients diagnosed with degenerative lumbar scoliosis in our hospital from March 2000 to March 2009 were reviewed retrospectively.The incidence,type and distribution of Modic changes were reviewed.Degree of Low back pain determined by VAS was compared between patients with and without Modic changes.The correlation between Modic changes and disc degeneration,slipping degree of endplate,lumbar scoliosis Cobb′s angle and body mass index(BMI)were analyzed.Result:Of 756 lumbar discs from 126 patients,Modic changes were observed in 124(18.2℅)discs from 69(54.8%) patients.The VAS score for patients with and without Modic changes was 55±20 and 30±15 respectively,which showed significant difference between them(P0.01).19(2.5%)discs of 15 patients(11.9%)were classified as typeⅠ,97(12.8%) discs of 48(38.1%) patients as type Ⅱ,8(1.1%)discs of 6 patients(4.8%) was type Ⅲ.32(25.8%) Modic degenerative discs were noted in L5/S1,26(21.0%) in L4/5,9(7.3%) in L3/4,47(37.9%) in L2/3,6(4.8%) in L1/2,4(3.2%) in T12/L1.99(13.1%) Modic changes were noted on concave side and 25(3.3%) on convex side,which showed significant difference between concave side and convex side(P0.01).Modic changes were significantly correlated with intervertebral disc degeneration,slipping degree of endplate,lumbar scoliosis Cobb′s angle and BMI(P0.05).Conclusion:Modic changes correlate with intervertebral disc degeneration,slipping degree of endplate,lumbar scoliosis Cobb′s angle and BMI,and the prevalences of Modic changes are L2/3,L5/S1 and L4/5,most of them are type Ⅱ and locate on the concave side.