Evidence map›Paper›PMID 41249666›Full record

ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2026

MRI radiomics reveals pain-related biomarkers for modic changes.

Sunqi Nian, Chengjin Li, Fei Chen, Caiwang Zhao, Guangyao Zhang, Na Li, Jiayu Chen

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Article in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

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7 authors.

Sunqi NianDepartment of Orthopedics, The First People's Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan, China.
Chengjin LiDepartment of Orthopedics, The First People's Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan, China.
Fei ChenDepartment of Orthopedics, The First People's Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan, China.
Caiwang ZhaoDepartment of Orthopedics, The First People's Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan, China.
Guangyao ZhangDepartment of Orthopedics, The First People's Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan, China.
Na LiDepartment of Anesthesiology, 920th Hospital of the Joint Logistics Support Force, Kunming, Yunnan, China. lina@kmmu.edu.cn.
Jiayu ChenDepartment of Orthopedics, The First People's Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan, China. jchenspine@163.com.

Funding

Additional support was provided by the Yunnan Provincial Key Laboratory of Digital Orthopedics 202005AG070004The Reserve Talents for Academic and Technical Leaders of Middle-aged and Young People in Yunnan Province 202305AC160069The Yunnan Province Ten Thousand People Plan Young Talent Program YNWR-QNBJ-2019-184The Yunnan Provincial Science and Technology Department/Kunming Medical University Joint Project of Basic Research 202301AY070001-080
6 · The paper itself

Abstract

backgroundModic changes (MC) are vertebral endplate abnormalities detectable on MRI, strongly linked to low back pain (LBP). Identifying imaging features correlated with pain severity may improve diagnosis and guide treatment. This study aims to develop an automated radiomics-based model for classifying MC and investigating its association with LBP severity.

methodsA total of 304 retrospective and 101 prospective patients with MRI-confirmed MC (January 2020–May 2024) were analyzed. Radiomic features were extracted from T1, T2, and FS sequences using Pyradiomics, yielding 1,906 features. The Mann-Whitney U-test and LASSO algorithm identified 29 key features. A Naive Bayes model was trained (70%) and validated (30%) using retrospective data. Prospective patient data, including Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI) scores, were analyzed for correlations with pain severity.

resultsThe model achieved 99% accuracy in classifying Modic types. Seven radiomic features showed significant associations with pain severity. Higher VAS scores correlated positively with short-run high gray-level emphasis and size-zone non-uniformity normalized, and negatively with low gray-level zone emphasis (all P < 0.05). ODI scores showed negative associations with 10th-percentile intensity, elongation, and median intensity, and a positive association with skewness (all P < 0.05). Additionally, focused volumetric analysis (mesh volume, voxel volume, surface area) revealed no linear or nonlinear associations with pain (all P > 0.05), indicating that texture-based inflammatory signatures rather than lesion size may better characterize Modic-related pain.

conclusionsThe radiomics-based Naive Bayes model accurately classifies Modic changes and identifies imaging features linked to LBP severity. These findings support improved diagnostics, early intervention, and personalized rehabilitation for MC-related spinal disorders.

Indexed as

Low Back PainLumbar VertebraeMagnetic Resonance ImagingAdultBiomarkersFemaleHumansMaleMiddle AgedPain MeasurementProspective StudiesRadiomicsRetrospective StudiesBiomarkersClassification modelModic changesPainRadiomics

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