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      Modic changes of the lumbar spine—their association with the lumbar sagittal parameters: A retrospective imaging study

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          Abstract

          Background

          The Lumbar sagittal parameters might be related to modic changes (MCs). However, studies on this topic have rarely been reported. The aim of this study was to identify the relationships between the lumbar sagittal parameters and the development of MCs.

          Methods

          The lumbar sagittal parameters of 321 patients with chronic low back pain from May 2016 to August 2018 were measured on X-ray by using Surgimap surgical planning software. Univariable analyses were used to test the potential variables of interest. Logistic regression models were then performed for the significant parameters to identify the independent factors associated with the development of MCs.

          Results

          More patients in the MCs group were older with more number of female than in the disc degeneration group ( p < 0.05). In the univariate analysis, significant differences were detected for the parameters of lumbar lordosis, sacral slope, intervertebral height index, endplate concave angle, and intervertebral angle only at the L5/S1 level between the two groups. The results of logistic regression analysis showed that a smaller intervertebral height index was positively associated with the development of MCs at the level of L3/4 ( p < 0.05). However, the positive role of gender was only for MCs at the L5/S1 level ( p < 0.05).

          Conclusions

          The results of this study revealed that there were negative relationships between the lumbar sagittal parameters and MCs. Furthermore, being female and having a narrow intervertebral space were the independent risk factors for the development of MCs at the corresponding lumbar levels. Interestingly, body mass index might be not associated with MCs for the Chinese population.

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          Most cited references26

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          Chapter 3. European guidelines for the management of acute nonspecific low back pain in primary care.

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            Imaging of degenerative disk disease.

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              Vertebral endplate signal changes (Modic change): a systematic literature review of prevalence and association with non-specific low back pain.

              The prevalence of "vertebral endplate signal changes" (VESC) and its association with low back pain (LBP) varies greatly between studies. This wide range in reported prevalence rates and associations with LBP could be explained by differences in the definitions of VESC, LBP, or study sample. The objectives of this systematic critical review were to investigate the current literature in relation to the prevalence of VESC (including Modic changes) and the association with non-specific low back pain (LBP). The MEDLINE, EMBASE, and SveMED databases were searched for the period 1984 to November 2007. Included were the articles that reported the prevalence of VESC in non-LBP, general, working, and clinical populations. Included were also articles that investigated the association between VESC and LBP. Articles on specific LBP conditions were excluded. A checklist including items related to the research questions and overall quality of the articles was used for data collection and quality assessment. The reported prevalence rates were studied in relation to mean age, gender, study sample, year of publication, country of study, and quality score. To estimate the association between VESC and LBP, 2 x 2 tables were created to calculate the exact odds ratio (OR) with 95% confidence intervals. Eighty-two study samples from 77 original articles were identified and included in the analysis. The median of the reported prevalence rates for any type of VESC was 43% in patients with non-specific LBP and/or sciatica and 6% in non-clinical populations. The prevalence was positively associated with age and was negatively associated with the overall quality of the studies. A positive association between VESC and non-specific LBP was found in seven of ten studies from the general, working, and clinical populations with ORs from 2.0 to 19.9. This systematic review shows that VESC is a common MRI-finding in patients with non-specific LBP and is associated with pain. However, it should be noted that VESC may be present in individuals without LBP.
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                Author and article information

                Contributors
                Ou.YF1972@gmail.com
                wang11doctor@foxmail.com
                Journal
                J Orthop Surg Res
                J Orthop Surg Res
                Journal of Orthopaedic Surgery and Research
                BioMed Central (London )
                1749-799X
                15 June 2020
                15 June 2020
                2020
                : 15
                : 220
                Affiliations
                [1 ]GRID grid.410652.4, ISNI 0000 0004 6003 7358, Department of Orthopedics, , People’s Hospital of Guangxi Zhuang Autonomous Region, ; Nanning, 530021 China
                [2 ]GRID grid.8664.c, ISNI 0000 0001 2165 8627, Institute of Anatomy and Cell Biology, , Justus-Liebig-University, ; 35392 Giessen, Germany
                [3 ]GRID grid.411858.1, ISNI 0000 0004 1759 3543, Faculty of Acupuncture, , Guangxi University of Chinese Medicine, ; Nanning, 530001 China
                Article
                1745
                10.1186/s13018-020-01745-z
                7296966
                32539789
                d90c7c38-4f37-4558-9440-92f36a90f721
                © The Author(s) 2020

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 4 February 2020
                : 5 June 2020
                Funding
                Funded by: Key Scientific Research Projects for Medicine and Health of Guangxi Zhuang Autonomous Region
                Award ID: Emphasis 2010029 and S2018026
                Award Recipient :
                Funded by: FundRef http://dx.doi.org/10.13039/501100010890, Chinese Government Scholarship;
                Award ID: 2018018180151
                Award Recipient :
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2020

                Surgery
                lumbar spine,vertebral endplate signal changes,modic changes,lumbar sagittal parameters,correlative factors,imaging study

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