The Distribution of Modic Changes and Their Clinical Implications in Patients Undergoing First-time Surgery for Lumbar Disc Herniation

Sang Shuhang; Ge Xiang; Yu Zhen; Zhang Dong

Abstract：Objective To explore the distribution characteristics of Modic changes(MC)in patients undergoing first-time surgery for lumbar disc herniation and analyze their association with age,sex,affected segments,and the degree of intervertebral disc degeneration.Methods Clinical and imaging data of 551 patients(2 755 spinal segments)who underwent first-time surgery for lumbar disc herniation between June 2018 and June 2022 at Suzhou Clinical College of Bengbu Medical University and Suzhou Municipal Hospital of Anhui Province were retrospectively analyzed.The cohort included 234 males and 317 females,aged 15 to 87 years[mean age(56.92±14.08)].Data on age,sex,affected segments,degree of intervertebral disc degeneration,and the type and distribution of MC were recorded.The distribution patterns of MC were described,and statistical analyses were conducted to evaluate the correlation between MC and lumbar disc degeneration.Results In the 2 755 spinal segments analyzed,the prevalence of MC was 12.6％.MC were most frequently observed at the L4～5 and L5 S1 levels,accounting for 83.5％of all MC cases.MC Ⅱ changes were the most common,comprising 89.6％of the cases.The incidence of MC increased with age(P＜0.05).The incidence of MC was slightly higher in females compared to males,though the difference was not statistically significant(P＞0.05).Apositive correlation was found between the presence of MC and the degree of intervertebral disc degeneration(P＜0.05).Conclusion In patients with lumbar disc herniation undergoing first-time surgery,MC is predominantly located in the lower lumbar segments,with Modic type Ⅱ being the most frequent;MC is positively correlated with age,vertebral segments,and lumbar degeneration,while no significant correlation is observed with gender.