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Novel Modic grading scoring system and its clinical validation: a preliminary investigation

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Abstract

Purpose

To propose a novel Modic grading scoring system and explore the relationship between the Modic grading score and disc degeneration, disc herniation, disc height, and clinical symptom scores.

Method

In total, 194 patients were included in the study. The new Modic grading scoring system included four indicators: invaded vertebral height, invaded endplate length, endplate morphology, and grade of endplate defects. The severity of Modic changes was visually quantified by numerical scores, and the kappa value was used to verify the interobserver and intraobserver reliability. Spearman correlation analysis was used to explore the relationship between the Modic grading score and intervertebral disc degeneration, disc herniation, disc height, and clinical symptom scores.

Results

The interobserver and intraobserver reliability showed substantial to almost perfect agreement in the new Modic grading scoring system. The Modic grading score was positively correlated with intervertebral disc degeneration (r = 0.757, p < 0.001) and negatively correlated with the intervertebral disc height index (r = − 0.231, p < 0.001). There was no significant correlation between the Modic grading scoring system and disc herniation (r = 0.369, p = 0.249). Additionally, there was no significant correlation between the Modic grading score and the Japanese Orthopaedic Association score (r = − 0.349, p = 0.25), Oswestry Disability Index score (r = 0.246, p = 0.11), or visual analogue scale score (r = 0.315, p = 0.35).

Conclusion

The new Modic grading scoring system had good interobserver and intraobserver reliability. The Modic grading score was positively correlated with intervertebral disc degeneration and negatively correlated with the intervertebral disc height.

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Data availability

The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

Not applicable.

Funding

This work was supported in part by the National Nature Science Foundation (81874022 and 82172483 to Xinyu Liu; 82102522 to Lianlei Wang), Key R & D Project of Shandong Province (2022CXGC010503 to Xinyu Liu), Shandong Natural Science Foundation (ZR202102210113 to Lianlei Wang) and Shandong Province Taishan Scholar Project (tsqn202211317 to Lianlei Wang).

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Author notes

  1. Hao Li, Liye Yu and Xianlei Gao contributed equally to this article.

Authors and Affiliations

  1. Department of Orthopedics, Qilu Hospital of Shandong University, Wenhua West Road 107#, Jinan, Shandong, 250012, People’s Republic of China

    Hao Li, Liye Yu, Xianlei Gao, Suomao Yuan, Yonghao Tian, Lianlei Wang & Xinyu Liu

  2. Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, People’s Republic of China

    Hao Li, Liye Yu & Xinyu Liu

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Contributions

HL, LYY, XLG is responsible for data collection, statistical analysis and writing the main manuscript text. LLW, SMY and YHT is responsible for statistical analysis and revising article. XYL proposed the concept and revised article finally. All authors reviewed the manuscript.

Corresponding authors

Correspondence to Lianlei Wang or Xinyu Liu.

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The authors declare that they have no competing interests.

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Ethical approval

This study was approved by the ethics committee of Qilu Hospital of Shandong University [KYLL-2021(KS)-055]. All methods were carried out in accordance with relevant guidelines and regulations.

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Li, H., Yu, L., Gao, X. et al. Novel Modic grading scoring system and its clinical validation: a preliminary investigation. Eur Spine J 33, 84–92 (2024). https://doi.org/10.1007/s00586-023-08003-w

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