Incidence and risk factors for modic changes in the lumbar spine: a systematic review and meta-analysis
BackgroundModic changes refer to bone marrow alterations beneath vertebral endplates and are potentially linked to infection, trauma, disc degeneration, scoliosis, and other pathological conditions. Systematic evaluations of their incidence and associated risk factors in the lumbar spine are lacking...
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Frontiers Media S.A.
2025-07-01
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| Series: | Frontiers in Endocrinology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fendo.2025.1585552/full |
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| author | Zhenyu Cao Zhenyu Cao Zhenyu Cao Mingtao Zhang Mingtao Zhang Jingwen Jia Jingwen Jia Guangzhi Zhang Guangzhi Zhang Lei Li Lei Li Zhili Yang Zhili Yang Feng Zheng Xuewen Kang Xuewen Kang |
| author_facet | Zhenyu Cao Zhenyu Cao Zhenyu Cao Mingtao Zhang Mingtao Zhang Jingwen Jia Jingwen Jia Guangzhi Zhang Guangzhi Zhang Lei Li Lei Li Zhili Yang Zhili Yang Feng Zheng Xuewen Kang Xuewen Kang |
| author_sort | Zhenyu Cao |
| collection | DOAJ |
| description | BackgroundModic changes refer to bone marrow alterations beneath vertebral endplates and are potentially linked to infection, trauma, disc degeneration, scoliosis, and other pathological conditions. Systematic evaluations of their incidence and associated risk factors in the lumbar spine are lacking. This study aimed to analyze and evaluate the incidence and risk factors of Modic changes in lumbar spine disorders.MethodsA comprehensive systematic review was conducted using Web of Science, PubMed, Cochrane Library, and Embase databases. Eligible studies reported the incidence and associated risk factors of Modic changes in the lumbar spine. Data were extracted and systematically analyzed from the selected studies, and meta-analyses were conducted employing random or fixed effects models.ResultsTwenty-five studies were included in the meta-analysis. The overall incidence of Modic changes was 35%. Six risk factors were identified and quantitatively assessed. Strong evidence supported the association of endplate changes (OR=3.56; 95% CI=2.00 to 6.32; p<0.0001); moderate evidence supported the association of age (OR=4.01; 95% CI=1.37 to 6.65; p=0.003), disc degeneration (OR=8.54; 95% CI=1.98 to 36.73; p=0.004), and lumbar lordosis angle (OR=-4.14; 95% CI=-6.79 to -1.49; p=0.002); minor evidence supported the association of spondylolisthesis (OR=2.00; 95% CI=1.12 to 3.58; p=0.02) and physical labor (OR=1.81; 95% CI=1.08 to 3.04; p=0.03) with the occurrence of Modic changes in the lumbar spine. No significant associations were found to support body mass index, sex, disc herniation, smoking, distributional segmentation, or sacral slope angle as risk factors for Modic changes in the lumbar spine.ConclusionModic changes occur in 35% of lumbar spine cases, with advanced age, disc degeneration, endplate changes, spondylolisthesis, reduced anterior lumbar lordosis angles, and participation in physical labor identified as associated risk factors. |
| format | Article |
| id | doaj-art-efbf5ad02add4163b28cdbeab6e7fa52 |
| institution | DOAJ |
| issn | 1664-2392 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Endocrinology |
| spelling | doaj-art-efbf5ad02add4163b28cdbeab6e7fa522025-08-20T02:46:02ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922025-07-011610.3389/fendo.2025.15855521585552Incidence and risk factors for modic changes in the lumbar spine: a systematic review and meta-analysisZhenyu Cao0Zhenyu Cao1Zhenyu Cao2Mingtao Zhang3Mingtao Zhang4Jingwen Jia5Jingwen Jia6Guangzhi Zhang7Guangzhi Zhang8Lei Li9Lei Li10Zhili Yang11Zhili Yang12Feng Zheng13Xuewen Kang14Xuewen Kang15Department of Orthopaedics, Lanzhou University Second Hospital, Lanzhou, Gansu, ChinaOrthopaedics Key Laboratory of Gansu Province, Lanzhou, Gansu, ChinaDepartment of Orthopaedics, Qinghai Provincial People’s Hospital, Xining, Qinghai, ChinaDepartment of Orthopaedics, Lanzhou University Second Hospital, Lanzhou, Gansu, ChinaOrthopaedics Key Laboratory of Gansu Province, Lanzhou, Gansu, ChinaDepartment of Orthopaedics, Lanzhou University Second Hospital, Lanzhou, Gansu, ChinaOrthopaedics Key Laboratory of Gansu Province, Lanzhou, Gansu, ChinaDepartment of Orthopaedics, Lanzhou University Second Hospital, Lanzhou, Gansu, ChinaOrthopaedics Key Laboratory of Gansu Province, Lanzhou, Gansu, ChinaDepartment of Orthopaedics, Lanzhou University Second Hospital, Lanzhou, Gansu, ChinaOrthopaedics Key Laboratory of Gansu Province, Lanzhou, Gansu, ChinaDepartment of Orthopaedics, Lanzhou University Second Hospital, Lanzhou, Gansu, ChinaOrthopaedics Key Laboratory of Gansu Province, Lanzhou, Gansu, ChinaDepartment of Orthopaedics, Qinghai Provincial People’s Hospital, Xining, Qinghai, ChinaDepartment of Orthopaedics, Lanzhou University Second Hospital, Lanzhou, Gansu, ChinaOrthopaedics Key Laboratory of Gansu Province, Lanzhou, Gansu, ChinaBackgroundModic changes refer to bone marrow alterations beneath vertebral endplates and are potentially linked to infection, trauma, disc degeneration, scoliosis, and other pathological conditions. Systematic evaluations of their incidence and associated risk factors in the lumbar spine are lacking. This study aimed to analyze and evaluate the incidence and risk factors of Modic changes in lumbar spine disorders.MethodsA comprehensive systematic review was conducted using Web of Science, PubMed, Cochrane Library, and Embase databases. Eligible studies reported the incidence and associated risk factors of Modic changes in the lumbar spine. Data were extracted and systematically analyzed from the selected studies, and meta-analyses were conducted employing random or fixed effects models.ResultsTwenty-five studies were included in the meta-analysis. The overall incidence of Modic changes was 35%. Six risk factors were identified and quantitatively assessed. Strong evidence supported the association of endplate changes (OR=3.56; 95% CI=2.00 to 6.32; p<0.0001); moderate evidence supported the association of age (OR=4.01; 95% CI=1.37 to 6.65; p=0.003), disc degeneration (OR=8.54; 95% CI=1.98 to 36.73; p=0.004), and lumbar lordosis angle (OR=-4.14; 95% CI=-6.79 to -1.49; p=0.002); minor evidence supported the association of spondylolisthesis (OR=2.00; 95% CI=1.12 to 3.58; p=0.02) and physical labor (OR=1.81; 95% CI=1.08 to 3.04; p=0.03) with the occurrence of Modic changes in the lumbar spine. No significant associations were found to support body mass index, sex, disc herniation, smoking, distributional segmentation, or sacral slope angle as risk factors for Modic changes in the lumbar spine.ConclusionModic changes occur in 35% of lumbar spine cases, with advanced age, disc degeneration, endplate changes, spondylolisthesis, reduced anterior lumbar lordosis angles, and participation in physical labor identified as associated risk factors.https://www.frontiersin.org/articles/10.3389/fendo.2025.1585552/fullmodic changelumbar spinelower back painmeta-analysisincidencerisk factor |
| spellingShingle | Zhenyu Cao Zhenyu Cao Zhenyu Cao Mingtao Zhang Mingtao Zhang Jingwen Jia Jingwen Jia Guangzhi Zhang Guangzhi Zhang Lei Li Lei Li Zhili Yang Zhili Yang Feng Zheng Xuewen Kang Xuewen Kang Incidence and risk factors for modic changes in the lumbar spine: a systematic review and meta-analysis Frontiers in Endocrinology modic change lumbar spine lower back pain meta-analysis incidence risk factor |
| title | Incidence and risk factors for modic changes in the lumbar spine: a systematic review and meta-analysis |
| title_full | Incidence and risk factors for modic changes in the lumbar spine: a systematic review and meta-analysis |
| title_fullStr | Incidence and risk factors for modic changes in the lumbar spine: a systematic review and meta-analysis |
| title_full_unstemmed | Incidence and risk factors for modic changes in the lumbar spine: a systematic review and meta-analysis |
| title_short | Incidence and risk factors for modic changes in the lumbar spine: a systematic review and meta-analysis |
| title_sort | incidence and risk factors for modic changes in the lumbar spine a systematic review and meta analysis |
| topic | modic change lumbar spine lower back pain meta-analysis incidence risk factor |
| url | https://www.frontiersin.org/articles/10.3389/fendo.2025.1585552/full |
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