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

Low back pain (LBP) is a prevalent health concern with various causes, including lumbar disc herniation (LDH) and vertebral endplate Modic changes (MCs). This study aimed to investigate the frequency and attributes of MCs in individuals diagnosed with LDH through magnetic resonance imaging (MRI).

This cross-sectional study analyzed MRI scans of 254 patients diagnosed with LDH at a referral hospital between 2021 and 2022. We assessed the presence, type, and location of MCs and the types of disc herniation. Statistical analyses examined the associations among MCs, LDH, age, and gender.

Among the participants (118 males and 136 females) with a mean age of 44.71 ± 13.14 years, MCs were identified in 31 individuals (12.2%), with Type II MCs being the most common (71.0%). The highest incidence of MCs was observed at the L5-S1 segment (41.9%). Age was significantly associated with herniated discs at L1-L2 (P = 0.041), L2-L3 (P = 0.002), and L3-L4 (P < 0.001), while gender was associated with L2-L3 level herniation (P = 0.012). The findings demonstrated a notable correlation between LDH and MC development, particularly Type II, with a significant prevalence at the L2-L3 level.

These findings underscore the importance of considering specific LDH levels and associated MCs in patient care and treatment strategies. Our study paves the way for future research, advocating for longitudinal studies to explore these relationships and their implications further, explore these relationships in more depth, and develop effective interventions for patients with LBP.