PREVALENCE AND CLINICAL SIGNIFICANCE OF THE COMBINATION OF INTERVERTEBRAL DISC HERNATION WITH MODIC CHANGES IN PATIENTS WITH CHRONIC LOW BACK PAIN
Keywords:
chronic low back pain, intervertebral disc herniation, Modic changes, risk factorsAbstract
The aim of the study was to investigate the prevalence, risk factors, and clinical significance of Modic changes (MC) in patients with chronic low back pain (CLBP) and intervertebral disc herniations. The study included 248 patients. MC were detected in 58.5% of cases, with type II predominating (68.7%) and most frequently localized at the L5–S1 level (52%). The main independent predictors of MC were the presence of disc herniation (OR 3.67), extrusion/sequestration (OR 2.31), duration of CLBP >12 months (OR 2.56), and age >50 years (OR 2.84). Patients with MC had significantly worse 12-month outcomes: higher pain intensity (VAS 4.8±1.9), greater functional impairment (ODI 31.4±11.2%), and lower return-to-work rate (64.8% vs 81.5%). The findings indicate that Modic changes are an important predictor of resistant CLBP and require a personalized approach to therapy and rehabilitation.
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