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. 2024 Oct 28;32(5):e278628.
doi: 10.1590/1413-785220243205e278628. eCollection 2024.

SMOKING AND MODIC CHANGES IN PATIENTS WITH CHRONIC LOW BACK PAIN: A COMPARATIVE STUDY

Guilherme Augusto Foizer  1   2 , Vagner Cleyton de Paiva  3 , Carlos Gorios  4 , Alberto Cliquet  5 , João Batista de Miranda  5
Affiliations

SMOKING AND MODIC CHANGES IN PATIENTS WITH CHRONIC LOW BACK PAIN: A COMPARATIVE STUDY

Guilherme Augusto Foizer et al. Acta Ortop Bras. .

Abstract
in English, Portuguese

Objective: To compare the prevalence of smokers among patients with chronic low back pain, in the presence and absence of Modic changes, also the correlation between smoking history and progression of the Modic scale.

Methods: Observational study, case-control type, with the inclusion of 340 vertebral segments in a total of 68 patients, separated into groups: with Modic (case group) and without Modic (control group). The odds ratio between the groups was verified using the Chi-Square test. Degree of correlation between smoking history (packs/year) and the degree of disc degeneration using Max-Modic and Sum-Modic, using Spearman's non-parametric test.

Results: The Modic group (MG) was 54% female and 46% male, with an average smoking history of 13.84 pack-years and an average of 1.42 altered segments per patient.

Conclusion: An increased risk for Modic changes was found among smoking patients (odds ratio [OR] 4.09; 95% CI, 1.26-12.31; p < 0.01) and significant correlation between Max-Modic, sum-Modic and smoking history. Level of Evidence III, Retrospective comparative study.

Objetivo: Comparar a prevalência de tabagistas entre os pacientes com lombalgia crônica, na presença e na ausência de alterações de Modic, bem como a correlação entre carga tabágica e progressão da escala de Modic. Método: Estudo observacional, tipo caso-controle, com a inclusão de 340 segmentos vertebrais em um total de 68 pacientes, separados em grupos: com alterações de Modic (grupo caso) e sem alterações de Modic (grupo controle). A razão de chances entre os grupos foi verificada por meio do teste Qui-Quadrado. Grau de correlação entre a carga tabágica (maços/ano) e o grau de degeneração discal através do Máximo-Modic e a Soma-Modic, por meio de teste não paramétrico de Spearman.

Resultados: O grupo Modic (GM) foi composto por 54% de pacientes do sexo feminino e 46% masculino, com média da carga tabágica de 13,84 anos/maço e média de 1,42 segmentos alterados por paciente. Conclusão: Foi encontrado um risco aumentado para alterações de Modic entre os pacientes tabagistas (razão de chances [OR] 4,09; IC 95%, 1,26-12,31; p < 0,01) e correlação significativa entre Máximo-Modic (r 0,3 p 0,01) e carga tabágica, assim como soma-Modic e carga tabágica (r 0,32 p 0,007). Nível de Evidência III, Estudo comparativo retrospectivo.

Keywords: Intervertebral Disc; Intervertebral Disc Degeneration; Low Back Pain; Magnetic Resonance Imaging; Tobacco Smoking.

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Conflict of interest statement

All authors declare no potential conflict of interest related to this article.

Figures

Figure 1.
Figure 1.. Sample size by outcome.
Figure 2.
Figure 2.. Average smoking load (packs/year).
Figure 3.
Figure 3.. Frequency of Modic change type in sample.
Figure 4.
Figure 4.. Modic changes (distribution per segment).
Figure 5.
Figure 5.. Correlation between Smoking Load and Maximum Modic.
Figure 6.
Figure 6.. Sum Modic Vs Smoking Load.
See this image and copyright information in PMC

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