Modic changes in the lumbar spine and their association with body composition, fat distribution and intervertebral disc height – a 3.0 T-MRI study

Teichtahl, Andrew; Urquhart, Donna M.; Wang, Yuanyuan; Wluka, Anita E.; O’Sullivan, Richard; Jones, Graeme; Cicuttini, Flavia Maria

doi:10.1186/s12891-016-0934-x

Cited by 29 publications

(37 citation statements)

References 30 publications

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“…Differences in the prevalence of disc degeneration and LBP symptoms between sexes have been reported [29]. Android pattern of fat distribution has been found to increase the risk of Modic change [30]. M2 may have a metabolic component in its aetiology [30].…”

Section: Discussionmentioning

confidence: 99%

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Chronic low back pain in relation to Modic changes, bony endplate lesions, and disc degeneration in a prospective MRI study

et al. 2016

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Purpose To clarify the significance of Modic changes, bony endplate lesions, and disc degeneration as predictors of chronic low back pain (LBP) during 1-year follow-up. Methods 49 patients with severe, non-specific, chronic LBP, and Modic 1 lesion (M1) were prospectively studied with MRI and questionnaire. Changes in grade of disc degeneration, severity of Modic changes, Schmorl lesions, and bony endplate irregularities were evaluated and changes assessed in LBP intensity on numeric rating scale 0-10 and severity with Oswestry disability index 0-100 (ODI). Association between change in MRI findings and symptoms was computed using generalized estimating equations analysis.Results Although pain decreased in most patients during 1-year follow-up, it increased or persisted in 36 %. Change in M1, M2, bony endplate lesions, and signal intensity (SI) and height of the disc associated with change of pain intensity, while change in M1, bony endplate lesions, and disc height associated with change of ODI. Not only persistent M1s, increasing bony endplate lesions, decreasing disc height, and M2s, but also new M2s predicted persistence of pain, while decrease of M1s and SI of the disc and increase of size of M2s predicted decrease of pain. Changes in disc bulges did not associate with pain. Conclusions In patients with chronic non-specific LBP, persisting M1, decreasing disc height, and increasing bony endplate lesions associated with persisting pain while decrease of SI of the disc with decrease of pain. Such changing MRI findings in the same disc space have earlier been shown to progress abnormally fast. They may be signs or biomarkers of a prolonged pain causing, deforming degenerative process, and should lead to considering early intervention or specific treatments to affect that process.

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Section: Discussionmentioning

confidence: 99%

“…Android pattern of fat distribution has been found to increase the risk of Modic change [30]. M2 may have a metabolic component in its aetiology [30]. Bone structure is known to depend on metabolic factors.…”

Section: Discussionmentioning

confidence: 99%

Chronic low back pain in relation to Modic changes, bony endplate lesions, and disc degeneration in a prospective MRI study

et al. 2016

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“…Such a comparison, however, may be virtually impossible because of lumbar aging, and thus, degeneration, from the second decade of life onward [27,28]. Third, although male gender and android fat distribution have been identified as risk factors for Modic degeneration, within the study~60% of patients with Modic changes were females, which may reflect institutional MRI habits [29]. Fourth, the retrospective PLSE assessment was based on highly fluid-sensitive, sagittal STIR sequences alone, but did not include transverse T2-weighted and STIR sections with complete lumbar coverage [4,11].…”

Section: Discussionmentioning

confidence: 87%

When an incidental MRI finding becomes a clinical issue

Schwarz‐Nemec

Friedrich

Arnoldner

et al. 2019

Wien Klin Wochenschr

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Background On magnetic resonance imaging (MRI), posterior lumbar subcutaneous edema (PLSE) is a frequent incidental, yet unclear finding within the deep subcutaneous perifascial tissue. This study aimed to investigate PLSE in various pathological lumbar conditions. Methods This retrospective study included the MR images of the lumbar spine of 279 patients (age range 18-82 years) without cardiovascular, renal or hepatic diseases, 79 of whom had low-grade disc degeneration, 101 combined endplate and facet joint degeneration, 53 axial spondyloarthritis and 46 infectious spondylodiscitis. There were 232 patients with a body mass index (BMI) <30, and 47 with a BMI ≥30 (obese). For each group, the relationship between PLSE and BMI was analyzed using multiple logistic regression, and between PLSE extension and BMI using ordinal regression.

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“…In those studies where the relationship between MCs and disc degeneration has been assessed previously, MCs frequently occur at sites with degenerative disc disease. [ 29 , 30 ] In a study by Maatta et al, the authors found that disc narrowing and disc signal loss were associated with prevalent MCs, even in multivariable analysis. [ 31 ] Kerttula et al reviewed 54 patients with large MCs and concluded that MCs were associated with decrease of disc height and change in disc signal intensity.…”

Section: Discussionmentioning

confidence: 99%

Predictive factors associated with neck pain in patients with cervical disc degeneration

et al. 2017

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The predictive factors associated with neck pain remain unclear. We conducted a cross-sectional study to assess predictive factors, especially Modic changes (MCs), associated with the intensity and duration of neck pain in patients with cervical disc degenerative disease.We retrospectively reviewed patients in our hospital from January 2013 to December 2016. Severe neck pain (SNP) and persistent neck pain (PNP) were the 2 main outcomes, and were assessed based on the numerical rating scale (NRS). Basic data, and also imaging data, were collected and analyzed as potential predictive factors. Univariate analysis and multiple logistic regression analysis were performed to assess the predictive factors for neck pain.In all, 381 patients (193 males and 188 females) with cervical degenerative disease were included in our study. The number of patients with SNP and PNP were 94 (24.67%) and 109 (28.61%), respectively. The NRS of neck pain in patients with type 1 MCs was significantly higher than type 2 MCs (4.8 ± 0.9 vs 3.9 ± 1.1; P = .004). The multivariate logistic analysis showed that kyphosis curvature (odds ratio [OR] 1.082, 95% confidence interval [CI] 1.044–1.112), spondylolisthesis (OR 1.339, 95% CI 1.226–1.462), and annular tear (OR 1.188, 95% CI 1.021–1.382) were factors associated with SNP, whereas kyphosis curvature (OR 1.568, 95% CI 1.022–2.394), spondylolisthesis (OR 1.486, 95% CI 1.082–2.041), and MCs (OR 1.152, 95% CI 1.074–1.234) were associated with PNP.We concluded that kyphosis curvature, spondylolisthesis, and annular tear are associated with SNP, whereas kyphosis curvature, spondylolisthesis, and MCs are associated with PNP. This study supports the view that MCs can lead to a long duration of neck pain.

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Modic changes in the lumbar spine and their association with body composition, fat distribution and intervertebral disc height – a 3.0 T-MRI study

Cited by 29 publications

References 30 publications

Chronic low back pain in relation to Modic changes, bony endplate lesions, and disc degeneration in a prospective MRI study

Chronic low back pain in relation to Modic changes, bony endplate lesions, and disc degeneration in a prospective MRI study

When an incidental MRI finding becomes a clinical issue

Predictive factors associated with neck pain in patients with cervical disc degeneration

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