<b>Modic Changes on MRI Lumbar Spine and Their Risk Factors in Patients Presenting to A Tertiary Care Hospital</b>

Background: Modic changes are vertebral endplate and adjacent bone marrow signal abnormalities detected on magnetic resonance imaging and are considered part of the degenerative disc disease spectrum. Their prevalence and associated risk factors have been widely studied internationally, but local data from Pakistan remain limited. Objective: To determine the frequency and subtype distribution of Modic changes on lumbar spine MRI and evaluate their association with demographic, anthropometric, lifestyle, and occupational risk factors among adults presenting to a tertiary care hospital. Methods: This cross-sectional observational study included 186 patients aged 30 years and above who underwent lumbar spine MRI at the Department of Diagnostic Radiology, Combined Military Hospital, Abbottabad. Demographic data, residence, BMI, smoking status, smoking exposure, occupational workload, and MRI findings were recorded. Modic changes were classified into Type I, Type II, and Type III according to standard MRI signal characteristics. Data were analyzed using SPSS version 23, and associations were assessed using the chi-square test, with p ≤ 0.05 considered statistically significant. Results: The mean age was 54.26 ± 14.23 years, and the mean BMI was 27.35 ± 3.74 kg/m². Modic changes were identified in 53 patients (28.5%), with Type II being the most frequent subtype. The presence of Modic changes was not significantly associated with gender, residence, BMI category, or occupational workload, while smoking showed a borderline association. Lesion burden was significantly associated with smoking status (p = 0.036) and occupational workload (p = 0.018), with multiple Modic changes more frequent among heavy labor workers. Conclusion: Modic changes were common among adults undergoing lumbar spine MRI, with Type II changes predominating. Heavy occupational workload was associated with greater lesion burden, suggesting a possible role of mechanical stress in vertebral endplate degeneration.