Effects of Modic Type 1 Changes in the Vertebrae on Low Back Pain

Hanımoğlu, Hakan; Çevik, Serdar; Yılmaz, Hakan; Kaplan, Abdullah; Çalış, Fatih; Katar, Salim; Evran, Şevket; Akkaya, Enes; Karaca, Onur

doi:10.1016/j.wneu.2018.09.132

Cited by 28 publications

(22 citation statements)

References 29 publications

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“…As we know, area ratios are regularly used in pathology as indexes of lesion severity, such as in estimating degree of myocardial infarctions, cerebral infarction, burn injury, and idiopathic femoral head osteonecrosis. Likewise, many studies have reported a positive correlation between MCs area ratios and lower back pain, especially MCs type I and type II [22,23].Our ndings show that the area ratios of MCs region had a signi cant correlation with the degrees of disc degeneration. As the area ratio becomes larger, the disc degeneration becomes more severe.…”

Section: Discussionsupporting

confidence: 77%

The correlation between the change of Hounsfield units value and Modic changes in the lumbar vertebral endplate

Zhu

Chen

et al. 2021

Preprint

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Objectives To evaluate the changes of Hounsfield units (HU) value in different types of Modic changes (MCs) and to analyze the correlation between the change of HU value and area ratio of MCs region, bone mineral density (BMD), and degree of intervertebral disc degeneration. Methods 158 endplates with MCs were included and analyzed. HU values of MCs regions and adjacent vertebral corresponding regions without MCs were measured. The area ratio of MCs region was defined as the area of MCs divided by the area of endplate or the vertebral sagittal plane. BMD was measured by Dual-energy x-ray absorptiometry (DXA). Degree of intervertebral disc degeneration was evaluated based on Pfirrmann classification. According to the types of variables, descriptive statistics, Kolmogorove-Smirnov test, paired t-test, Wilcoxon signed-rank test, Independent-Samples T Test, and Pearson correlation analysis were used. Results The HU values in any types of MCs are significantly higher than that of adjacent vertebral corresponding regions without MCs(P < 0.001). The HU value of the type III MCs is higher than that of the type I and type II MCs. HU value was positively correlated with BMD. In the levels with Grade V disc degeneration, the area ratio of MCs region was significant increased. Conclusions HU values of the vertebral endplate and bone marrow were increased in most MCs regions with all types of MCs. HU value of endplates had a significantly positive correlation with BMD. Higher area ratio of MCs region is associated with more severe intervertebral disc degeneration.

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Section: Discussionsupporting

confidence: 77%

The correlation between the change of Hounsfield units value and Modic changes in the lumbar vertebral endplate

Zhu

Chen

et al. 2021

Preprint

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“…biosoft.hacettepe.edu.tr/easyROC/). AUC values < 0.6 have been regarded as uninformative, and values 0.6 to 0.7 as indicating poor discrimination [34]. We thus regarded our sample size to be sufficiently large.…”

Section: Discussionmentioning

confidence: 99%

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

Bråten

Schistad

Espeland

et al. 2020

BMC Musculoskelet Disord

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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.

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“…STIR series are sensitive to edema and are highly relevant for evaluation of MCs. The association between MCs and pain is inconsistent (13)(14)(15)(16), but edema type MCs might be symptomatic (17)(18)(19). Mechanical, autoimmune, and infectious explanations for MCs have been proposed (20), and various treatments have been and are being tested (21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34).…”

Section: Introductionmentioning

confidence: 99%

Short tau inversion recovery MRI of Modic changes: a reliability study

Kristoffersen

Vetti

Storheim

et al. 2020

Acta Radiologica Open

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Background: Limited reliability data exist for evaluation of spinal edema changes on magnetic resonance imaging (MRI) with short tau inversion recovery (STIR) sequences. Purpose: To assess the inter-observer reliability for evaluation of STIR signal increase related to Modic changes (MCs) on MRI of the lumbar spine. Material and Methods: We prospectively included 120 patients imaged to confirm their eligibility for the AIM (Antibiotics In Modic changes) trial. Three experienced radiologists independently evaluated MCs on T1-/T2-weighted fast spin-echo images and subsequently MC-related STIR signal increases. Inter-observer reliability was analyzed at four endplates (L4-S1) by calculating kappa values and means of differences with 95% limits of agreement. Results: Overall agreement (mean Fleiss' kappa for all endplates and observers) was very good for presence of STIR signal increase (0.86), and moderate for its categorized height (0.51), anteroposterior extent (0.48), and volume (0.56). For height of region with STIR signal increase measured in % points of vertebral body height, the largest mean of differences was 6.9 and widest range for limits of agreement was AE22.3 for all endplates combined. The corresponding numbers were 11.2 AE 34.5 for anteroposterior extent of the STIR signal increase measured in % points of anteroposterior endplate diameter and 0.9 AE 7.6 for its maximum measured intensity on a % point scale (0% ¼ normal vertebral marrow intensity, 100% ¼ cerebrospinal fluid intensity). Conclusion: Inter-observer reliability was very good for the presence and intensity of MC-related STIR signal increases, and moderate for their size.

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Effects of Modic Type 1 Changes in the Vertebrae on Low Back Pain

Cited by 28 publications

References 29 publications

The correlation between the change of Hounsfield units value and Modic changes in the lumbar vertebral endplate

The correlation between the change of Hounsfield units value and Modic changes in the lumbar vertebral endplate

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

Short tau inversion recovery MRI of Modic changes: a reliability study

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