Does Modic Change Progresss With Age?

STUDY DESIGN: Cross-sectional imaging study.

OBJECTIVE: The aim of this study was to clarify the trend in the generation distinctions about the prevalence of Modic change (MC) including elderly patients.

SUMMARY OF BACKGROUND DATA: MC has been discussed regarding its clinical significance, relationship with low back pain, suitable treatments, prevalence, and natural history. However, previous reports have focused on younger subjects, with few studies conducted in elderly patients. If MC is actually a progressive condition of a patient, then it should become more common as the patient ages. We herein report the distribution of MC across several age groups.

METHODS: Patients who underwent lumbar magnetic resonance imaging (MRI) in our institution from April 2013 to March 2015 were recruited. MC was assessed using T1- and T2-weighted magnetic resonance imaging (MRI) and divided into Modic types (MT) 1, 2, and 3, and mixed type. Trends in the prevalence of MC were analyzed based on age.

RESULTS: We ultimately included 585 patients of an initial 937 who underwent lumbar MRI. The mean age was 65 years. MC was identified in 36.0% of the patients. The prevalence of MC by age was 0% for those in their 10 s, 10% for those in their 20 s, 33% for those in their 30 s, 27% for those in their 40 s, 32% for those in their 50 s, 44% for those in their 60 s, 42% for those in their 70 s, and 26% for those in their 80 s. By type, 3.3% were MT1, 81.3% were MT2, 0.5% were MT3, and 14.8% were mixed type.

CONCLUSION: The prevalence of MC increased with age to some degree, with the highest frequency observed in individuals in their 60 s before declining in those in their 70 s and 80 s. These findings suggest that MC might not simply progress with age, particularly after the seventh decade of life.

LEVEL OF EVIDENCE: 4.