Modic changes following lumbar disc herniation |
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Authors: | Hanne B Albert Claus Manniche |
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Institution: | (1) The Back Research Center, Part of Clinical Locomotion Science, University of Southern Denmark, Lindevej 5, 5750 Ringe, Denmark |
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Abstract: | Only a small proportion (20%) of patients with LBP can be diagnosed based on a patho-anatomical entity. Therefore, the identification
of relevant subgroups, preferably on a patoanatomical basis, is strongly needed. Modic changes have been described by several
authors as being closely linked with LBP. The aims of this study were to describe the prevalence of Modic changes, their development
as well as their association to LBP, previous disc contour, and surgery in patients with previous severe sciatica. This is
a longitudinal cohort study where the patients were recruited from an RCT comparing two active conservative treatments, the
181 patients, who at baseline had radicular pain in or below the knee; all underwent a physical examination and MRI. MRI’s,
pain history and physical examination of 166 patients were obtained at follow-up 14 months later. The prevalence of Modic
changes type 1 increased from 9% at baseline to 29% at follow-up. At that time, a strong association between Modic changes
and non-specific LBP was noted. Apparently, Modic changes type 1 was more strongly associated with non-specific lumbar pain
than Modic changes type 2. The development of new Modic changes was closely related to the level of a previous disc herniation.
A lumbar disc herniation is a strong risk factor for developing Modic changes (especially type 1) during the following year.
Furthermore, Modic changes are strongly associated with LBP. |
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Keywords: | Low back pain Modic changes MRI Disc herniation Vertebral endplates changes |
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