Modic changes and their associations with clinical findings

Abstract

It is believed that disc degeneration (DD) is, in general, only mildly associated with low back pain (LBP). MRI-identified Modic changes (MC), probably a late stage of DD, are relatively strongly associated with LBP but it is not known if people with MC also have a specific clinical profile. The purpose of this study was to investigate if the clinical findings differ in people with Modic changes (MC) as compared to those with only degenerative disc findings or none at all. In a population-based sample of 412 40-year-old Danes, information was collected independently with MRI, questionnaires and clinical examination. Three subgroups of people were created: those with both DD and MC, those with only DD, and those with neither DD nor MC. The clinical pattern was investigated for each subgroup in order to test the assumption that the clinical picture differs in the three groups. It was expected that people with both DD and MC would have a more pronounced clinical profile than those with only DD who, in turn, would differ from those with neither of these two MRI findings. Our findings were generally in concordance with our expectations. MC constitutes the crucial element in the degenerative process around the disc in relation to LBP, history, and clinical findings. People with DD and no MC only vaguely differ from those without. People with LBP and MC may deserve to be diagnosed as having specific LBP.

Vertebral endplate signal changes (Modic change): a systematic literature review of prevalence and association with non-specific low back pain

“…As expected, the prevalence of VESC increases with age [87,106]. This seems plausible as VESC is correlated to disc degeneration [80,106], which in turn is correlated to age [15].…”

“…In all these cases, consensus was obtained without difficulties by authors 1 and 5. A total of 60 papers were excluded after review; 27 as they dealt with specific LBP conditions ( Table 2) and 33 for other reasons: one review article [55], four case reports [7,27,129,148], one double publication [90], one of two studies reporting data from the same study sample [80], ten for evaluating signal changes other than those related to the endplate [6,20,51,53,71,113,116,139,146,150], and eight articles because they did not report the exact numbers needed to calculate the prevalence rates of VESC [4,10,109,110,114,122,133,141]. Finally, eight articles were excluded because the study samples were selected on the basis of the presence of VESC [41, 50,56,63,68,134,137,149].…”

Are early MRI findings correlated with long-lasting symptoms following whiplash injury? A prospective trial with 1-year follow-up

“…The population had no considerable neck trouble prior to the whiplash injury and data on pre-existing findings most likely represent findings as in a general population. Modic changes that are shown to be highly related to pain when present in the lumbar spine [19], were also present in the cervical spine. Most Modic changes were observed at the end-plates adjacent to a herniated disc.…”

Modic changes: “Age, si quid agis”

“…For the Modic Type I/II, clinical outcome was comparable to those presenting with pure Modic Type I changes (P \ 0.01). In the Modic Type 0 group, patients were also significantly improved for both VAS and JOA scores, but in a lower proportion rather than Modic Type I and I/II groups (P = 0.0395) [3].…”

“…I read with interest the article ''Modic changes and their associations with clinical findings'' from Kjaer et al [3]. The authors stated that that the aim of their study was not to specifically identify the clinical profile of people with Modic changes (MCs), but mainly to investigate if MC is a separate entity, one that would deserve to be treated as a potential diagnostic subgroup with specific clinical consequences.…”