SMOKING AND MODIC CHANGES IN PATIENTS WITH CHRONIC LOW BACK PAIN: A COMPARATIVE STUDY

Area of Science:

• Spinal Imaging and Degeneration
• Epidemiology of Musculoskeletal Disorders
• Tobacco Use and Health

Background:

• Chronic low back pain is a prevalent condition often associated with degenerative changes in the spine.
• Modic changes, a type of degenerative alteration in the vertebral bone marrow, are frequently observed in patients with low back pain.
• The role of lifestyle factors, such as smoking, in the development and progression of Modic changes requires further investigation.

Purpose of the Study:

• To compare the prevalence of smokers in patients with chronic low back pain, with and without Modic changes.
• To investigate the correlation between smoking history and the progression of Modic changes on spinal imaging.

Main Methods:

• An observational case-control study was conducted involving 68 patients (340 vertebral segments).
• Patients were categorized into groups with and without Modic changes.
• Statistical analyses included the Chi-Square test for odds ratio and Spearman's non-parametric test for correlation with smoking history (pack-years).

Main Results:

• The group with Modic changes (MG) showed an average smoking history of 13.84 pack-years.
• An increased risk of Modic changes was observed in smoking patients (Odds Ratio [OR] 4.09).
• A significant correlation was found between smoking history (pack-years) and the severity of Modic changes (Max-Modic and Sum-Modic scores).

Conclusions:

• Smoking is associated with a significantly higher risk of developing Modic changes in patients with chronic low back pain.
• A notable correlation exists between the extent of smoking and the progression of Modic changes.
• These findings highlight smoking as a potential risk factor for Modic changes in the spine.