Prevalence of Modic Changes in Active Duty Military Men With Lumbar Disk Herniation Who Were Scheduled for Surgery

Vredeveld, Tom; Teitsma, Xavier M; Mert, Agali; Wurff, Peter van der

doi:10.1016/j.jmpt.2012.09.007

Cited by 3 publications

(2 citation statements)

References 23 publications

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“…There is no known ethnic predilection for MC across the globe. Kanna et al 62 recently reported a prevalence of 13% in a cohort of 809 Indian patients, while Vredeveld et al 63 reported 28.6% prevalence of MC among European military personnel. In general, most studies report MC II lesions as commonest sub-type followed by MC I.…”

Section: In Asymptomatic Populationmentioning

confidence: 98%

Modic changes - An evidence-based, narrative review on its patho-physiology, clinical significance and role in chronic low back pain

Viswanathan

Shetty

Rajasekaran

2020

Journal of Clinical Orthopaedics and Trauma

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Objective: Lumbar degenerative spinal ailments are the most important causes for chronic low back pain. Modic changes (MC) are vertebral bone marrow signal intensity changes seen on MRI, commonly in association with degenerative disc disease (DDD). Despite being widely studied, majority of issues concerning MC are still controversial. The current narrative, evidence-based review comprehensively discusses the various aspects related to MC. Literature search: An elaborate search was made using keywords "Modic changes", "lumbar Modic changes", "Modic changes in lumbar spine", and "vertebral Endplate Spinal Changes", on pubmed and google (scholar.google.com) databases on the 3rd of March 2020. We identified crucial questions regarding Modic changes and included relevant articles pertaining to these topics for this narrative review. Results: The initial search using the keywords "Modic changes", "lumbar Modic changes", "Modic changes in lumbar spine", and "vertebral Endplate Spinal Changes" on pubmed yielded a total of 568, 412, 394 and 216 articles on "pubmed" database, respectively. A similar search using the aforementioned keywords yielded a total of 3650, 3548, 3726 and 21570 articles on "google scholar" database. The initial screening involved exclusion of duplicate articles, articles unrelated to MC, animal or other non-clinical studies, and articles in non-English literature based on abstracts or the titles of articles. This initial screening resulted in the identification of 405 articles. Full manuscripts were obtained for all these selected articles and thoroughly scrutinised at the second stage of article selection. All articles not concerning Modic changes, not pertaining to concerned questions, articles concerning other degenerative phenomena, articles discussing cervical or thoracic MC, case reports or animal studies, articles in non-English language and duplicate articles were excluded. Review articles, randomised controlled trials and level 1 studies were given preference. Overall, 69 articles were included in this review. Conclusion: Modic change (MC) is a dynamic phenomenon and its true etiology is still not definitely known. Disc/end plate injury, occult discitis and autoimmune reactions seem to trigger an inflammatory cascade, which leads to their development. Male sex, older age, diabetes mellitus, genetic factors, smoking, obesity, spinal deformities, higher occupational loads and DDD are known risk factors. There is no conclusive evidence on the causative role of MC in chronic low back pain (LBP) or any influence on the long term outcome in patients with LBP or lumbar disc herniations (LDH). Patients with MC have been reported to have less satisfactory outcome following conservative treatment or discectomy, although the evidence is still unclear.

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Section: In Asymptomatic Populationmentioning

confidence: 98%

Modic changes - An evidence-based, narrative review on its patho-physiology, clinical significance and role in chronic low back pain

Viswanathan

Shetty

Rajasekaran

2020

Journal of Clinical Orthopaedics and Trauma

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“…(58) However, a pre-surgical study population is likely different from the sample evaluated in this study. Cheung, also using MRI, found higher rates of LDD with age in a general population sample, though L5-1 was again the most common level to show degeneration.…”

Section: Discussionmentioning

confidence: 97%

Prevalence of Radiographic Findings in Individuals With Chronic Low Back Pain Screened for a Randomized Controlled Trial: Secondary Analysis and Clinical Implications

Vining

Potocki

McLean

et al. 2014

Journal of Manipulative and Physiological Therapeutics

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Objective The purpose of this study is to measure the prevalence of graded disc degeneration, spondylolisthesis, transitional segmentation and the distribution of sacral slope in patients 21 to 65 years of age with chronic low back pain (CLBP). Methods This retrospective study analyzed 247 digital lumbar radiographic series obtained during a randomized controlled trial of chiropractic patients with CLBP. CLBP was defined as pain in the low back lasting 12 weeks or longer. Radiographic findings of disc degeneration, spondylolisthesis, and lumbosacral transitional segmentation were graded by 2 authors using established classification criteria. Sacral slope was measured with a digital tool contained within imaging software. Results Lumbosacral transitional segments graded I – IV (Castellvi classification) were present in 14% of cases. Lumbar disc degeneration was most prevalent at L3-4 (49%) followed by L4-5 (42%), L2-3 (41%), L5-S1 (37%), and L1-2 (29%). Isthmic spondylolisthesis was present in 5% of cases with L5 the most common location. Degenerative spondylolisthesis demonstrated a prevalence rate of 18%, most commonly occurring at L4. The prevalence of degenerative spondylolisthesis was 51% for females aged 50–59 and 24% for males in the same age range. Conclusions Moderate-severe disc degeneration, multi-level disc narrowing, and degenerative spondylolisthesis were common in individuals with CLBP over age 40. Isthmic spondylolisthesis was not more prevalent than what has been reported in other populations. Transitional segmentation was identified in a minority of participants with some of these exhibiting accessory joints or fusion. Mean sacral slope in individuals with CLBP was not substantially different from mean slopes reported in other populations.

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From Modic to Disc Endplate Bone Marrow Complex - The Natural Course and Clinical Implication of Vertebral Endplate Changes

Rajasekaran,

Ramachandran,

K S

et al. 2024

Global Spine Journal

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Study Design Review article. Objectives A review of literature on the epidemiology, natural course, pathobiology and clinical implications of vertebral endplate changes. Methods A literature search was performed using the Cochrane Database of Systematic Reviews, EMBASE, and PubMed. Studies published over the last 10 years were analysed. The searches were performed using Medical Subject Headings terms, and the subheadings used were “Vertebral endplate changes”, “Modic changes”, “Disc Endplate Bone Marrow complex”. Results The disc, endplate (EP), and bone marrow region of the spine constitute a unified morphological and functional unit, with isolated degeneration of any one structure being uncommon. Disc degeneration causes endplate defects, which result in direct communication and a constant cross-talk between the disc and the vertebral body. This may result in a persistent inflammatory state of the vertebral bone marrow, serving as a major pain generator. This review article focuses on vertebral endplate changes and how the current understanding has progressed from the Modic classification to the Disc Endplate Bone Marrow complex classification. It provides a clear portrayal of the natural course of these alterations and their clinical implications in low back pain. Conclusions In light of the heightened interest and current prominence of vertebral endplate changes within the spine community, we must progress beyond the Modic changes to achieve a comprehensive understanding. The DEBM complex classification will play a major part in disc degeneration research and clinical care, representing a considerable advancement in our understanding of the vertebral endplate changes over the classical Modic changes.

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Prevalence of Modic Changes in Active Duty Military Men With Lumbar Disk Herniation Who Were Scheduled for Surgery

Cited by 3 publications

References 23 publications

Modic changes - An evidence-based, narrative review on its patho-physiology, clinical significance and role in chronic low back pain

Modic changes - An evidence-based, narrative review on its patho-physiology, clinical significance and role in chronic low back pain

Prevalence of Radiographic Findings in Individuals With Chronic Low Back Pain Screened for a Randomized Controlled Trial: Secondary Analysis and Clinical Implications

From Modic to Disc Endplate Bone Marrow Complex - The Natural Course and Clinical Implication of Vertebral Endplate Changes

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