Vertebral Bone Mineral Measures and Psychological Wellbeing among Individuals with Modic Changes

Abstract

PurposeThis case-control pilot study examined whether vertebral bone mineral measures were associated with the presence of chronic low back pain (CLBP) and Modic changes (MCs), and to compare psychological wellbeing and inflammation among individuals with CLBP and MCs, compared to individuals with no history of low back pain and without MCs.MethodsEleven individuals with MRI-defined MCs in the lumbar spine and CLBP (cases) and 10 individuals with no history of CLBP or MCs (controls) responded to standard questionnaires regarding pain characteristics and psychological health. Bone mineral density (BMD) was measured with postero-anterior and lateral-projection dual energy X-ray absorptiometry (DXA) to estimate areal BMD (aBMD) and apparent volumetric BMD (ap.vBMD). High sensitivity serum C-reactive protein (hsCRP) was measured as an index of inflammation.ResultsWhile there was no difference between the groups in measures of depression, anxiety and stress, cases reported significantly greater pain catastrophizing attitudes (P < 0.01). hsCRP concentrations did not differ between groups (P = 0.54). Among the 7 cases where MCs were identified between L3–4, significantly higher mean aBMD was observed at the affected vertebral level, compared to the adjacent, unaffected, cephalad level (P = 0.01–0.04), but not when ap.vBMD was calculated (P = 0.36).ConclusionsVertebral BMD is not reduced among individuals with CLBP and MCs compared to a control group, although pain catastrophizing attitudes are increased among individuals with CLBP and MCs.

Subregional DXA-Derived Vertebral Bone Mineral Measures are Stronger Predictors of Failure Load in Specimens with Lower Areal Bone Mineral Density, Compared to Those with Higher Areal Bone Mineral Density

“…Consistent with previous investigations, this study confirms that vertebral aBMD and BMC measured by lateral-projection DXA vary within the vertebral body [13,22,3]. In accordance with existing literature [33,18,19,41], BMC was found to be a strong predictor of ultimate vertebral failure load, and a substantially greater proportion of variance in failure load could be explained by BMC when measured using lateral-projection DXA, compared with PA-projection DXA (e.g., R 2 =0.86 vs. 0.57).…”

“…While generally less precise than postero-anterior (PA)-projection scans, bone mineral measurements derived from lateral-projection scans may have the potential to improve fracture prediction estimates. Despite the general low acceptance of lateral-projection scanning, largely attributed to poorer precision and relative lack of reference data, a web of evidence points to the potential clinical utility of bone mineral data derived from lateral-projection scans compared to PAprojection scans, including a stronger association with vertebral failure strength [18,19], superior diagnostic sensitivity [20,21,14,22,23] and greater sensitivity to changes in bone mineral measurements with therapy [24][25][26][27] or ageing [21]. However, despite greater sensitivity to changes in bone mineral measurements with therapy, Blake et al [24] concluded that PA-projection measures are the most suitable for longitudinal studies.…”

Bone mineral density and bone remodeling markers in chronic low back pain patients with active discopathy: A case-control exploratory study

“…We found no significant difference between type 1 and 0 MC groups in total lumbar spine, total femur and femoral neck BMD. Only one case-control study has addressed the question of BMD in cLBP patients with MC [ 29 ] and found no significant difference between cases (n = 11) and controls (n = 10) in total lumbar spine BMD. In 7 cases of MC identified at the L3-L4 level, mean BMD was higher at the affected level than the adjacent, unaffected cephalad level [ 29 ].…”

Psychological Well-being: A Preliminary Study of Guidance and Counseling Services Development of Preservice Teachers in Indonesia

“…Previous findings (Hill et al, 2019;Briggs, 2012) discovered that psychological well-being influenced a person's mental health; hence, it has to be prepared from early age as preventive and developmental efforts (Mock et al, 2019). Therefore, counseling and guidance services should offer positive impact on pre-service teacher's personal growth.…”