Correlation of Vertebral Bone Mineral Density and Modic Changes in Menopausal Females with Chronic Low Back Pain / 中国医学影像学杂志

ABSTRACT

PurposeIt has been reported that women have higher incidence of Modic changes than men and it may be related to the change of female hormone levels during menopause which leads to osteoporosis and other factors. This paper investigated the relationship between vertebral bone mineral density (BMD) of menopausal female suffering from chronic low pain and lumbar vertebral Modic changes on MRI, to explore the effect of vertebral bone mineral density upon Modic changes.Materials and Methods A total of 205 menopausal women with chronic low back pain were enrolled and underwent vertebral bone mineral density measurement and lumbar MRI examination. The bone mass of vertebral body and bone imaging data were observed. All patients were divided into three groups according to their level of bone mass group of normal bone mass 128 cases; osteopenia group 58 cases; osteoporosis group 19 cases. The incidence rate of Modic changes was compared among the three groups and the relationship between bone mineral density and vertebral Modic changes was further analyzed.Results Among 205 patients, 128 were with normal bone mass, 44 had Modic changes (type I 19 cases; type II 22 cases; type III 3 cases) and the incidence rate was 34.4%; osteopenia occurred in 58 patients, among whom 34 had Modic changes (type I 15 cases; type II 17 cases; type III 2 cases), which showed that the rate was 58.6%; 19 patients presented osteoporosis, 15 of whom appeared Modic changes (type I 6 cases, type II 7 cases;type III 2 cases), with the rate of 78.9%. There was statistically signiifcant difference in incidence rate of Modic changes among the three groups (χ2=18.995,P0.05).Conclusion Lumbar vertebral bone mineral density is correlated to the incidence of vertebral Modic changes in menopausal women with chronic low back pain. With the loss of vertebral bone mass, the incidence of vertebral Modic changes gradually rise. However, the correlation is rather weak; Modic change is a dynamic process, which is also influenced by other factors except vertebral bone mineral density.