The Relationship Between Facet Joint Osteoarthritis and Modic Changes of the Lumbar Spine: a Retrospective Magnetic Resonance Imaging Study

Abstract

Objectives: This study aims to assess the facet joint osteoarthritis in patients with lumbar Modic changes and to investigate the relationship between the Modic types and severity of the facet joint degeneration. Patients and methods: A total of 120 patients (55 males, 65 females; mean age 55.18 +/- 9.47 years; range 40 to 75 years) were included in the study. The patients were divided into four equal groups of 30 patients according to Modic type (No Modic changes, type 1, type 2, type 3). All groups were matched with age, sex, and spinal level. A total of 180 lumbar facet joints of the patients with Modic changes (60 facet joints for each Modic type) and 60 lumbar facet joints of the patients without Modic changes were analyzed. The severity of the facet joint osteoarthritis was assessed. The degree of the facet degeneration was evaluated by using the Pathria grading system with magnetic resonance imaging. Results: Facet joint degeneration increased gradually, as the type of Modic change increased. Compared to the group without Modic changes, all three groups with Modic changes had more degenerative facet joints (all p <= 0.002). The severity of the facet joint degeneration was significantly higher in type 3 versus type 1 Modic changes (p=0.022). Conclusion: Our study results suggest that Modic changes, particularly type 3, are strongly associated with the facet joint osteoarthritis of the lumbar spine. Clinically, facet joint degeneration should be considered in the examination of low back pain inpatients with Modic changes.