Significance of Relationship Between Lumbar Disc Degeneration and Modic Changes in Acute Disc Herniation

Objective:  To determine the significance of the relationship between lumbar disc degeneration and Modic changes in acute disc herniation. Materials and Methods:  This study included 323 patients 25 to 42 years of age having acute symptoms of acute single-level lumbar disc herniation. A simple random sampling technique was used to enroll these patients. MRI lumbosacral spine 1.5 tesla was done on all patients. The patients and MRIs were evaluated by a consultant neurosurgeon and anesthetist both having more than five years of clinical experience. The disc herniations, their types, disc degeneration by Pfirrmann grading, Modic changes in end plates, their types, and location were assessed. Results:  The mean age was 34.2±3 years. Males were 185 and females were 138. A total of 1615 discs from L1 to S1 of 323 patients were evaluated. 785 (48.6%) discs had degeneration, 356(22.0%) discs had herniation, 339(20.9%) discs had Modic changes. Out of the 356 herniated discs, 347(97.4%) discs had disc degeneration while 9(2.5%) discs did not have degeneration with a p-value <0.001. Out of the 356 herniated discs, 66(18.5%) discs had Modic changes while 290(81.4%) discs did not have Modic changes with a p-value <0.001. Conclusion:  We conclude that disc degeneration and Modic changes had a significant association with acute disc herniation.