Cao Zhenyu, Zhang Mingtao, Jia Jingwen, Zhang Guangzhi, Li Lei, Yang Zhili, Zheng Feng, Kang Xuewen
Department of Orthopaedics, Lanzhou University Second Hospital, Lanzhou, Gansu, China.
Orthopaedics Key Laboratory of Gansu Province, Lanzhou, Gansu, China.
Front Endocrinol (Lausanne). 2025 Jul 30;16:1585552. doi: 10.3389/fendo.2025.1585552. eCollection 2025.
Modic 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.
A 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.
Twenty-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.
Modic 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.
Modic改变是指椎体终板下的骨髓改变，可能与感染、创伤、椎间盘退变、脊柱侧弯及其他病理状况有关。目前缺乏对腰椎Modic改变的发生率及其相关危险因素的系统评估。本研究旨在分析和评估腰椎疾病中Modic改变的发生率及危险因素。
使用Web of Science、PubMed、Cochrane图书馆和Embase数据库进行全面的系统评价。符合条件的研究报告了腰椎Modic改变的发生率及其相关危险因素。从选定的研究中提取数据并进行系统分析，采用随机或固定效应模型进行荟萃分析。
25项研究纳入荟萃分析。Modic改变的总体发生率为35%。确定了6个危险因素并进行了定量评估。有力证据支持终板改变与之相关（比值比[OR]=3.56；95%置信区间[CI]=2.00至6.32；p<0.0001）；中等证据支持年龄（OR=4.01；95%CI=1.37至6.65；p=0.003）、椎间盘退变（OR=8.54；95%CI=1.98至36.73；p=0.004）和腰椎前凸角（OR=-4.14；95%CI=-6.79至-1.49；p=0.002）与之相关；微弱证据支持腰椎滑脱（OR=2.00；95%CI=1.12至3.58；p=0.02）和体力劳动（OR=1.81；95%CI=1.08至3.04；p=0.03）与腰椎Modic改变的发生相关。未发现有力证据支持体重指数、性别、椎间盘突出、吸烟、节段分布或骶骨倾斜角是腰椎Modic改变的危险因素。
35%的腰椎病例存在Modic改变，高龄、椎间盘退变、终板改变、腰椎滑脱、腰椎前凸角减小和从事体力劳动被确定为相关危险因素。
