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Association Between Lumbar Disc Herniation and Vertebral Endplate Modic Changes: An MRI-Based Study.

Pegah Torabi¹, Ghazaleh Jamalipour Soufi¹, Ali Hekmatnia¹

¹Department of Radiology, Isfahan University of Medical Sciences, Isfahan, Iran.

Advanced Biomedical Research

|October 24, 2025

Summary

Modic changes (MCs) are linked to lumbar disc herniation (LDH). Type II MCs were most common, especially at L5-S1, with significant correlations found between LDH levels, age, and gender.

Keywords:

Disc degeneration intervertebral disc herniation low back pain lumbar magnetic resonance imaging spine

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Area of Science:

Radiology and Imaging
Spinal Disorders
Musculoskeletal Diseases

Background:

Low back pain (LBP) is a widespread issue with diverse origins.
Lumbar disc herniation (LDH) and Modic changes (MCs) are common causes of LBP.
Understanding the relationship between LDH and MCs is crucial for effective LBP management.

Purpose of the Study:

To determine the frequency and characteristics of Modic changes (MCs) in patients diagnosed with lumbar disc herniation (LDH).
To analyze the association between MCs, LDH, patient demographics (age, gender), and herniation levels.

Main Methods:

Cross-sectional analysis of 254 lumbar spine MRI scans from patients with confirmed LDH.
Assessment of MC presence, type, and location, alongside LDH characteristics.
Statistical analysis to identify correlations between MCs, LDH, age, and gender.

Main Results:

Modic changes (MCs) were present in 12.2% of patients with lumbar disc herniation (LDH).
Type II MCs were the most prevalent (71.0%), frequently observed at the L5-S1 segment (41.9%).
Significant associations were found between age and herniation at L1-L2, L2-L3, and L3-L4 levels, and between gender and L2-L3 herniation.

Conclusions:

A significant correlation exists between lumbar disc herniation (LDH) and the development of Modic changes (MCs), particularly Type II.
The L2-L3 spinal level showed a notable prevalence of both LDH and associated MCs.
These findings emphasize the importance of considering MCs in LDH diagnosis and treatment planning, suggesting further longitudinal research.