title: The location of Modic changes in the lumbar spine: a meta-analysis.
abstract: This meta-analysis was to study the location of Modic changes in the lumbar spine.
  
  
  
  The electronic databases including MEDLINE, Web of science, Cochrane Central Register of Controlled Trials, OVID, CBM were searched. Relevant studies that described the patients with Modic Changes were included. Data were extracted and analysed using the version 12.0 STATA software.
  
  
  
  Thirty-one studies were selected and analyzed (2346 total patients). No significant differences of the incidence of MC were identified between superior and the inferior end plates adjacent to discs [RR = 1.04, 95 % CI (0.74, 1.53)], the same result was detected for the distribution of MC type I between L4/5 and L5/S1 [RR = 0.80, 95 % CI (0.64, 1.02)]. While lower lumbar spine (L4/5, L5/S1) had significant greater incidence of MC [RR = 0.20, 95 % CI (0.15, 0.25)], especially in L5/S1 [RR = 0.82, 95 % CI (0.72, 0.92)]. For MC type II, it also significantly appeared in L5/S1 [RR = 0.80, 95 % CI (0.67, 0.95), P = 0.010].
  
  
  
  In this study, Modic Changes was more common in the lowest two levels, especially in L5/S1. Additionally, the sub-types (type I and type II) were also more likely to appear in L5/S1. It appeared that there existed a correlation between MC and biomechanics. And it seemed that local biomechanical stress might contributed to the distribution of MC and the conversion of type I to type II for the patients treated conservatively.
authors.affiliation: The Department of Orthopedics Surgery, Second Affiliated Hospital of Wenzhou Medical University, 109# XueYuan Western Road, Wenzhou, 325027, Zhejiang, People's Republic of China.
authors.forename: Zhe-Yu
authors.initials: ZY
authors.lastname: Huang
authors.affiliation: The Department of Orthopedics Surgery, Second Affiliated Hospital of Wenzhou Medical University, 109# XueYuan Western Road, Wenzhou, 325027, Zhejiang, People's Republic of China.
authors.forename: Hai-Chao
authors.initials: HC
authors.lastname: Xu
authors.affiliation: The Department of Orthopedics Surgery, Second Affiliated Hospital of Wenzhou Medical University, 109# XueYuan Western Road, Wenzhou, 325027, Zhejiang, People's Republic of China.
authors.forename: Tao
authors.initials: T
authors.lastname: Lei
authors.affiliation: The Department of Orthopedics Surgery, Second Affiliated Hospital of Wenzhou Medical University, 109# XueYuan Western Road, Wenzhou, 325027, Zhejiang, People's Republic of China.
authors.forename: Qing-Long
authors.initials: QL
authors.lastname: Li
authors.affiliation: The Department of Orthopedics Surgery, Second Affiliated Hospital of Wenzhou Medical University, 109# XueYuan Western Road, Wenzhou, 325027, Zhejiang, People's Republic of China.
authors.forename: Ai-Min
authors.initials: AM
authors.lastname: Wu
authors.affiliation: The Department of Orthopedics Surgery, Second Affiliated Hospital of Wenzhou Medical University, 109# XueYuan Western Road, Wenzhou, 325027, Zhejiang, People's Republic of China. wenfeini@yeah.net.
authors.forename: Wen-Fei
authors.initials: WF
authors.lastname: Ni
mesh_terms: D006801:Humans; D007403:Intervertebral Disc / Q000000981:diagnostic imaging / Q000473:pathology*; D055959:Intervertebral Disc Degeneration / Q000000981:diagnostic imaging / Q000473:pathology*; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology*; D008279:Magnetic Resonance Imaging
keywords: Degeneration; Location; Lumbar spine; Modic change(s); Vertebral endplate(s)