The influence of spinal-pelvic parameters on the prevalence of endplate Modic changes in degenerative thoracolumbar/lumbar kyphosis patients

Xia, Weiwei; Liu, Chenjun; Duan, Shuo; Xu, Shuai; Wang, Kaifeng; Zhu, Zhenqi; Liu, Haiying

doi:10.1371/journal.pone.0197470

Cited by 16 publications

(28 citation statements)

References 24 publications

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“…Farshad-Amacker et al [21] performed a long-term follow-up study to look for the predictors for the development of lumbar degeneration in terms of LDD and MCs, but they did not find the relationships between LL, SS, and the development of MCs. However, another study [15] with the contradictory results reported that the endplates with MCs in degenerative thoracolumbar/lumbar kyphosis were negatively correlated with LL ( r = − 0.562, P = 0.012) and SS ( r = − 0.46, P = 0.048). Obviously, the different conclusions of the above studies were based on different research subjects.…”

Section: Discussionmentioning

confidence: 99%

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Patients with Modic type 2 change have a severe radiographic representation in the process of lumbar degeneration: a retrospective imaging study

Lan

Wang

et al. 2019

J Orthop Surg Res

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Background There are few studies to investigate changes in imaging parameters of Modic changes (MCs). The imaging studies examining the distinctions in the lumbar sagittal parameters between MCs and lumbar disc degeneration (LDD) are still lacking. The purpose of this study was to identify the differences in the lumbar sagittal parameters among patients for LDD with/without Modic type 2 change (MII). Methods A total of 208 patients with lumbar degenerative disease from January 2017 to August 2018 volunteered for this study. Sixty-two patients with MII were used as the MC group. The other 146 patients served as the disc degeneration (DD) group. The DD scores and sagittal parameters were measured on magnetic resonance imaging (MRI) and X-ray by using Surgimap software. Results The prevalence of MII for patients with degenerative lumbar diseases in this study was 29.81%, primarily located at L5/S1. There were significant differences in lumbar lordosis (LL) and sacral slope (SS) between these two groups ( P < 0.05). Similarly, the significant decrease in intervertebral height index (IHI) was found at L3-S1 in the MC group, compared with the DD group ( P < 0.05). However, a significant difference in intervertebral angle (IVA) was observed only at L5/S1 ( P < 0.05). The MC group had the smaller endplate concave angle (ECA) than the DD group from L3 caudal endplate to S1 cranial endplate ( P < 0.05). Conclusions MII has a severe radiographic representation in the process of lumbar degeneration than patients without MII, and the overconcentration of load caused by the smaller LL, SS, and IVA may be a reasonable explanation to answer why MCs are more common at the L5/S1.

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Section: Discussionmentioning

confidence: 99%

“…Because degenerative sagittal imbalance can alter the axial stress of spinal motion unit, then, long-term axial stress can undoubtedly lead to the lesions of endplate and intervertebral disc. Meanwhile, deformation of intervertebral disc and endplate can in turn aggravate the sagittal imbalance of lumbar spine [15].…”

Section: Introductionmentioning

confidence: 99%

Patients with Modic type 2 change have a severe radiographic representation in the process of lumbar degeneration: a retrospective imaging study

Lan

Wang

et al. 2019

J Orthop Surg Res

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“…Although FCLs are observed in axSpA, they are also present in degenerative and other spinal disorders [23] which could contribute to the differences in specificity. Among all vertebral levels, the thoracic spine is the least affected by degeneration [24, 25], rendering a more accurate diagnostic tool for axSpA.…”

Section: Discussionmentioning

confidence: 99%

Fatty corner lesions in T1-weighted magnetic resonance imaging as an alternative to sacroiliitis for diagnosis of axial spondyloarthritis

et al. 2019

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Background A fatty corner lesion (FCL) is a well-demarcated fat infiltration in the corner of a vertebral body on T1 magnetic resonance imaging (MRI) sequence. It has been reported to be useful in the diagnosis of axial spondyloarthritis (axSpA). Our objective is to systematically evaluate the diagnostic accuracy of FCLs in tertiary centre patients with chronic back pain. Method Two hundred and thirty eight axSpA patients and 62 non-axSpA patients with back pain were recruited from five rheumatology centres. Clinical, biochemical, and radiological parameters were collected and all patients underwent a MRI of the spine and sacroiliac (SI) joints. FCLs in vertebral bodies from C4 to L5 were scored. The number and location of FCLs were clustered together to determine an optimal combination for diagnosis. Results were compared with expert diagnosis as the “gold standard”. Results FCLs of the anterior whole spine (AUC 0.62; p = 0.003) and anterior thoracic spine (AUC 0.64; p = 0.001) had diagnostic significance. Incorporating at least 5 whole spine FCLs into the imaging criteria of the Assessment of SpondyloArthritis international Society (ASAS) criteria for axSpA yielded a sensitivity of 91.6% and specificity of 91.9%. Similarly, applying at least 3 anterior thoracic FCLs to the imaging criteria of the ASAS axial SpA criteria yielded a sensitivity of 92.0% and specificity of 93.5%. Conclusion FCLs could be used to diagnose axial SpA. The presence of at least 3 anterior thoracic FCLs in T1-weighted MRI spine suggests a diagnosis of axial SpA without additional MRI of the SI joints. Trial registration The cohort has been registered in the clinical trial registry of the University of Hong Kong ( HKUCTR-2087 ). Electronic supplementary material The online version of this article (10.1186/s41927-019-0068-5) contains supplementary material, which is available to authorized users.

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“…SS is used to evaluate the normal variation in the sagittal plane of the adult human lumbar spine and pelvis in the standing position [27]. A recent study reported by Xia et al [28] supports that the amount of MCs was significantly correlated with LL and SS. This is coincident with our study.…”

Section: Lumbar Sagittal Parametersmentioning

confidence: 90%

“…This is coincident with our study. The associations of LL and SS with risk of MCs may be due to decreased axial decompression ability of the spine and an increased shear force on the vertebral endplate [28]. This would increase the risk of endplate and cancellous bone damage when the spine is subjected to external forces in the perpendicular direction [29].…”

Section: Lumbar Sagittal Parametersmentioning

confidence: 99%

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

Mu¹,

Peng²,

Yu³

et al. 2020

J Orthop Surg Res

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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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The influence of spinal-pelvic parameters on the prevalence of endplate Modic changes in degenerative thoracolumbar/lumbar kyphosis patients

Cited by 16 publications

References 24 publications

Patients with Modic type 2 change have a severe radiographic representation in the process of lumbar degeneration: a retrospective imaging study

Patients with Modic type 2 change have a severe radiographic representation in the process of lumbar degeneration: a retrospective imaging study

Fatty corner lesions in T1-weighted magnetic resonance imaging as an alternative to sacroiliitis for diagnosis of axial spondyloarthritis

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

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