Refined Phenotyping of Modic Changes: Imaging Biomarkers of Prolonged Severe Low Back Pain and Disability

Low back pain (LBP) is the world's most disabling condition. Modic changes (MC) are vertebral bone marrow changes adjacent to the endplates as noted on magnetic resonance imaging. The associations of specific MC types and patterns with prolonged, severe LBP and disability remain speculative. Th...

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Bibliographic Details
Published in:Medicine (Baltimore) 2016-05, Vol.95 (22), p.e3495-e3495
Main Authors: Määttä, Juhani H., Karppinen, Jaro, Paananen, Markus, Bow, Cora, Luk, Keith D.K., Cheung, Kenneth M.C., Samartzis, Dino
Format: Article
Language:English
Subjects:
China - epidemiology
Cross-Sectional Studies
Disability Evaluation
Disabled Persons - rehabilitation
Female
Follow-Up Studies
Humans
Incidence
Life Style
Low Back Pain - diagnosis
Low Back Pain - epidemiology
Low Back Pain - rehabilitation
Lumbar Vertebrae - diagnostic imaging
Magnetic Resonance Imaging - methods
Male
Middle Aged
Observational Study
Pain Measurement
Phenotype
Reproducibility of Results
Severity of Illness Index
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Summary:Low back pain (LBP) is the world's most disabling condition. Modic changes (MC) are vertebral bone marrow changes adjacent to the endplates as noted on magnetic resonance imaging. The associations of specific MC types and patterns with prolonged, severe LBP and disability remain speculative. This study assessed the relationship of prolonged, severe LBP and back-related disability, with the presence and morphology of lumbar MC in a large cross-sectional population-based study of Southern Chinese.We addressed the topographical and morphological dimensions of MC along with other magnetic resonance imaging phenotypes (eg, disc degeneration and displacement) on the basis of axial T1 and sagittal T2-weighted imaging of L1-S1. Prolonged severe LBP was defined as LBP lasting ≥30 days during the past year, and a visual analog scale severest pain intensity of at least 6/10. An Oswestry Disability Index score of 15% was regarded as significant disability. We also assessed subject demographics, occupation, and lifestyle factors.In total, 1142 subjects (63% females, mean age 53 years) were assessed. Of these, 282 (24.7%) had MC (7.1% type I, 17.6% type II). MC subjects were older (P = 0.003), had more frequent disc displacements (P 
ISSN:0025-7974
1536-5964
DOI:10.1097/MD.0000000000003495