Investigation of relationship between lumbar Modic changes and serum vitamin D concentrations

INTRODUCTION: There is limited and inconsistent data on the relationship between vitamin D deficiency and Modic changes (MCs). Also, which type of MCs is associated with vitamin D is not clear. Vitamin D has anti-inflammatory effects, while type 1 MCs have inflammatory nature. Accordingly, patients with type 1 may have lower vitamin D levels than those with type 2 MCs. This study aimed to compare type 1 and type 2 MCs for serum vitamin D concentrations.
METHODS: Between May 2019 and July 2020, a total of 53 patients with type 1 or type 2 MCs were included in this study. Patients’ demographics were recorded, and back pain severity was assessed by using visual analog scale. Serum levels of vitamin D were measured as total 25 hydroxy vitamin D. Accordingly, serum levels of vitamin D (µg/L) are graded as deficient (<20), insufficient (20-30), and sufficient (30-80).
RESULTS: Type 1 MCs (n=26) and type 2 MCs (n=27) groups were similar in age (p=0.199), gender (p=0.372), BMI (p=0.418), work status (p=0.593), pain duration (p=0.947), vitamin D concentration (p=0.402), degree of vitamin D deficiency (p=0.773), and spinal levels (p=0.726). Type 1 MCs patients had more painful low back than type 2 MCs patients (p=0.016).
DISCUSSION AND CONCLUSION: Type 1 MCs are similar to type 2 MCs for serum vitamin D concentration. The more painful low back of type 1 MCs may be related to its inflammatory nature, but may not be associated with vitamin D insufficiency.