Vertebral Endplate Changes Are Not Associated with Chronic Low Back Pain among Southern European Subjects: A Case Control Study

Kovacs, Francisco M.; Arana, Estanislao; Royuela, Ana; Estremera, Ana; Amengual, Guillermo; Asenjo, Beatriz; Sarasíbar, H.; Galarraga, Isabel; Alonso, Ana; Casillas, Carlos; Muriel, Alfonso; Martı́nez, Carmen Enid; Abraira, Víctor

doi:10.3174/ajnr.a3087

Cited by 33 publications

(32 citation statements)

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“…Additionally, in an immunohistochemical study, Ohtori et al detected the presence of tumor necrosis factor in a vertebral body endplate with Modic changes and reported this as a cause of low back pain 19) . On the other hand, Kovacs et al reported no association of chronic low back pain with Modic changes 20) . In the present study, the presence of Modic changes was not associated with low back pain.…”

Section: Discussionmentioning

confidence: 99%

Spinal fusion on adolescent idiopathic scoliosis patients with the level of L4 or lower can increase lumbar disc degeneration with sagittal imbalance 35 years after surgery

Akazawa

Kotani

Sakuma

et al. 2017

Spine Surg Relat Res

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Abstract:Introduction: The purpose of this study was to investigate the long-term incidence of lumbar disc degeneration and Modic changes in the non-fused segments of patients with adolescent idiopathic scoliosis (AIS) who previously underwent spinal fusion.Methods: Study subjects consisted of 252 patients with AIS who underwent spinal fusion between 1968 and 1988. Of 252 patients, 35 subjects underwent lumbar spine MRI and whole spine X-ray examination. The mean patient age at the time of follow-up was 49.8 years, with an average follow-up period of 35.1 years. We classified the subjects into two groups based on the lowest fused vertebra: H group whose lowest fused vertebra was L3 or higher levels and L group whose lowest fused vertebra was L4 or lower levels.Results: The L group had significantly advanced disc degeneration on MRI. There was no significant difference between two groups in Modic changes. The L group showed less lumbar lordosis than the H group (H group: 48.1 degrees; and L group: 32.1 degrees) and greater SVA (H group: 1.2 cm; and L group: 5.5 cm).Conclusions: In AIS patients, 35 years after spinal fusion surgery on average, we evaluated lumbar disc degeneration and Modic changes of the non-fused segments. In patients with the lowest fusion level at L4 or lower, there were reduced lumbar lordosis, considerable SVA imbalance, and severe disc degeneration compared with those with the lowest fusion level at L3 or higher. The lowest fusion level at L3 or higher is recommended to reduce disc degeneration in midlife.

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Section: Discussionmentioning

confidence: 99%

Spinal fusion on adolescent idiopathic scoliosis patients with the level of L4 or lower can increase lumbar disc degeneration with sagittal imbalance 35 years after surgery

Akazawa

Kotani

Sakuma

et al. 2017

Spine Surg Relat Res

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“…1 The concerns he voices open a worthy debate. We believe that radiologists' decisions on the findings that should be included in their reports should stem from the evidence on clinical relevance and not from their reporting patterns or personal styles.…”

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confidence: 99%

“…1,2 2) The lifetime prevalence of LBP among the general population is Ͼ70%, 3 and Ͼ80% of subjects show VEC (irrespective of whether they report LBP or a history of LBP). 1 3) Spinal fusion is an aggressive form of treatment, while its effectiveness appears to be similar to that of intensive exercise. 4 4) Nevertheless, some surgical societies recommend spinal fusion for patients who present with VEC and report LBP 5 ; if one takes into account points 2 and 3, this means that most of the population would qualify for spinal fusion at some point in their lives.…”

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confidence: 99%

“…Therefore, we think that including epidemiologic data or omitting clinically irrelevant findings from radiologic reports may contribute to protecting patients from aggressive unnecessary forms of overtreatment. 1 It is indeed advisable for examination requisitions to include relevant clinical information, but its absence would not be an obstacle for these approaches because it is the responsibility of the medical referral personnel to assess the concordance between clinical and potentially relevant radiologic findings (eg, disk herniation or spinal stenosis).…”

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Kovacs¹,

Arana²,

Royuela³

et al. 2012

AJNR Am J Neuroradiol

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Degenerative Veränderungen der Wirbelsäule

Pennekamp

2013

Internist

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Unspecific back pain is a common phenomenon. Imaging often shows no clear cause for the genesis of back pain and generally has no impact on the therapeutic procedure. In contrast specific back pain, where a morphological cause is present is more infrequent. In these cases imaging and especially magnetic resonance imaging (MRI) is indicated. The indications for imaging should be geared to the so-called red flags which suggest serious morphological changes of the spine. The article deals with often encountered degenerative changes of the spine and describes spondylodiscitis as an important differential diagnosis to erosive osteochondritis.

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Vertebral Endplate Changes Are Not Associated with Chronic Low Back Pain among Southern European Subjects: A Case Control Study

Cited by 33 publications

References 45 publications

Spinal fusion on adolescent idiopathic scoliosis patients with the level of L4 or lower can increase lumbar disc degeneration with sagittal imbalance 35 years after surgery

Spinal fusion on adolescent idiopathic scoliosis patients with the level of L4 or lower can increase lumbar disc degeneration with sagittal imbalance 35 years after surgery

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Degenerative Veränderungen der Wirbelsäule

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