Association of Modic change types and their short tau inversion recovery signals with clinical characteristics- a cross sectional study of chronic low back pain patients in the AIM-study

Abstract

Background: Modic Changes (MCs, magnetic resonance imaging (MRI) signal changes in the vertebral bone marrow extending from the vertebral endplate) may represent a subgroup of nonspecific chronic low back pain that could benefit from a specific management. The primary aim was to compare clinical characteristics between patients with type 1 versus type 2 MCs. The secondary aim was to explore associations between clinical characteristics and MC related short tau inversion recovery (STIR) signals. Methods:This cross-sectional study used baseline data prospectively collected between 2015 and 2017 on the 180 patients included in the AIM-study (Antibiotics In Modic changes), a randomized controlled trial in a Norwegian hospital out-patient setting of patients with chronic low back pain, a lumbar disc herniation within the last 2 years, low back pain intensity score ≥ 5 (on a 0-10 scale) and current type 1 or type 2 MCs at the previously herniated lumbar disc level. We used prespecified clinical characteristics including self-report measures, physiologic measures and functional measures from clinical history and examination. The diagnostic accuracy of various clinical characteristics to discriminate between patients with type 1 MCs (with or without additional type 2 MCs) and patents with type 2 MCs only (not type 1) were assessed by calculating the area under the receiver-operating curve. We assessed the correlations of clinical characteristics with details of MC related STIR signal increase.

Quantifying Bone Marrow Edema Adjacent to the Lumbar Vertebral Endplate on Magnetic Resonance Imaging: A Cross-Sectional Study of Patients with Degenerative Lumbar Disease

“…These studies differ in that the former focused on the extent of BME, while we focused on the SI of BME on MRI. Our findings agreed with those reported in a study showing no clinically relevant correlations with short tau inversion recovery signal increase on MRI [ 23 ]. The association between LBP severity and BME on MRI is controversial; further research is necessary to confirm any correlation between LBP severity and BME.…”

The Relationship between Spondylolisthesis and Modic Changes: An MRI Study

“…However, grade 1 and grade 2 spondylolisthesis groups were similar to each other for the proportion of type 1 MCs. It is known that type 1 and type 2 MCs have interconvertible properties, and type 2 MCs has more stable structure (9,17). Therefore, the increased type 2 MCs seen in patients with grade 2 spondylolisthesis may be due to a conversion of type 1 and the stability of type 2 MCs.…”

Long-Term Use of Amoxicillin Is Associated with Changes in Gene Expression and DNA Methylation in Patients with Low Back Pain and Modic Changes

“…Furthermore, while our gene expression analysis included patients with only MC type I, the DNA methylation analysis additionally included data from 16 patients with MC type II. However, as MC types I and II are regarded as interconvertible and do not appear to represent clinical differences [32], these patients are likely to respond similarly to amoxicillin treatment in terms of gene expression or DNA methylation outcomes. Additionally, other tissues, such as saliva, should be explored to complete the picture of potential side effects of the treatment [33].…”