Is the development of Modic changes associated with clinical symptoms?

A 14-month cohort study with MRI

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

PURPOSE: Modic changes (MCs) have been suggested to be a diagnostic subgroup of low back pain (LBP). However, the clinical implications of MCs remain unclear. For this reason, the aims of this study were to investigate how MCs developed over a 14-month period and if changes in the size and/or the pathological type of MCs were associated with changes in clinical symptoms in a cohort of patients with persistent LBP and MCs. METHODS: Information on LBP intensity and detailed information from MRI on the presence, type and size of MCs was collected at baseline and follow-up. Changes in type (Type I, II, III and mixed types) and size of MCs were quantified at both time points according to a standardised evaluation protocol. The associations between change in type, change in size and change in LBP intensity were calculated using odds ratios (ORs). RESULTS: Approximately 40 % of the MCs followed the expected developmental path from Type I (here Type I or I/II) to Type II (here Type II or II/III) or Type I to Type I/II. In general, the bigger the size of the MC at baseline, the more likely it was that it remained unchanged in size after 14 months. Patients who had MC Type I at both baseline and 14-month follow-up were less likely to experience an improvement in their LBP intensity as compared to patients who did not have Type I changes at both time points (OR 7.2, CI 1.3-37). There was no association between change in size of MCs Type I and change in LBP intensity. CONCLUSIONS: The presence of MCs Type I at both baseline and follow-up is associated with a poor outcome in patients with persistent LBP and MCs.
Original languageEnglish
JournalEuropean Spine Journal
Volume21
Issue number11
Pages (from-to)2271-2279
ISSN0940-6719
DOIs
Publication statusPublished - 2012

Fingerprint

Low Back Pain
Cohort Studies
Odds Ratio

Cite this

@article{0a82b0614a0e4104949f6761533a1b8b,
title = "Is the development of Modic changes associated with clinical symptoms?: A 14-month cohort study with MRI",
abstract = "PURPOSE: Modic changes (MCs) have been suggested to be a diagnostic subgroup of low back pain (LBP). However, the clinical implications of MCs remain unclear. For this reason, the aims of this study were to investigate how MCs developed over a 14-month period and if changes in the size and/or the pathological type of MCs were associated with changes in clinical symptoms in a cohort of patients with persistent LBP and MCs. METHODS: Information on LBP intensity and detailed information from MRI on the presence, type and size of MCs was collected at baseline and follow-up. Changes in type (Type I, II, III and mixed types) and size of MCs were quantified at both time points according to a standardised evaluation protocol. The associations between change in type, change in size and change in LBP intensity were calculated using odds ratios (ORs). RESULTS: Approximately 40 {\%} of the MCs followed the expected developmental path from Type I (here Type I or I/II) to Type II (here Type II or II/III) or Type I to Type I/II. In general, the bigger the size of the MC at baseline, the more likely it was that it remained unchanged in size after 14 months. Patients who had MC Type I at both baseline and 14-month follow-up were less likely to experience an improvement in their LBP intensity as compared to patients who did not have Type I changes at both time points (OR 7.2, CI 1.3-37). There was no association between change in size of MCs Type I and change in LBP intensity. CONCLUSIONS: The presence of MCs Type I at both baseline and follow-up is associated with a poor outcome in patients with persistent LBP and MCs.",
author = "Jensen, {Rikke Kr{\"u}ger} and Charlotte Leboeuf-Yde and Niels Wedderkopp and Sorensen, {Joan S} and Jensen, {Tue S} and Claus Manniche",
year = "2012",
doi = "10.1007/s00586-012-2309-9",
language = "English",
volume = "21",
pages = "2271--2279",
journal = "European Spine Journal",
issn = "0940-6719",
publisher = "Heinemann",
number = "11",

}

Is the development of Modic changes associated with clinical symptoms? A 14-month cohort study with MRI. / Jensen, Rikke Krüger; Leboeuf-Yde, Charlotte; Wedderkopp, Niels; Sorensen, Joan S; Jensen, Tue S; Manniche, Claus.

In: European Spine Journal, Vol. 21, No. 11, 2012, p. 2271-2279.

Research output: Contribution to journalJournal articleResearchpeer-review

TY - JOUR

T1 - Is the development of Modic changes associated with clinical symptoms?

T2 - A 14-month cohort study with MRI

AU - Jensen, Rikke Krüger

AU - Leboeuf-Yde, Charlotte

AU - Wedderkopp, Niels

AU - Sorensen, Joan S

AU - Jensen, Tue S

AU - Manniche, Claus

PY - 2012

Y1 - 2012

N2 - PURPOSE: Modic changes (MCs) have been suggested to be a diagnostic subgroup of low back pain (LBP). However, the clinical implications of MCs remain unclear. For this reason, the aims of this study were to investigate how MCs developed over a 14-month period and if changes in the size and/or the pathological type of MCs were associated with changes in clinical symptoms in a cohort of patients with persistent LBP and MCs. METHODS: Information on LBP intensity and detailed information from MRI on the presence, type and size of MCs was collected at baseline and follow-up. Changes in type (Type I, II, III and mixed types) and size of MCs were quantified at both time points according to a standardised evaluation protocol. The associations between change in type, change in size and change in LBP intensity were calculated using odds ratios (ORs). RESULTS: Approximately 40 % of the MCs followed the expected developmental path from Type I (here Type I or I/II) to Type II (here Type II or II/III) or Type I to Type I/II. In general, the bigger the size of the MC at baseline, the more likely it was that it remained unchanged in size after 14 months. Patients who had MC Type I at both baseline and 14-month follow-up were less likely to experience an improvement in their LBP intensity as compared to patients who did not have Type I changes at both time points (OR 7.2, CI 1.3-37). There was no association between change in size of MCs Type I and change in LBP intensity. CONCLUSIONS: The presence of MCs Type I at both baseline and follow-up is associated with a poor outcome in patients with persistent LBP and MCs.

AB - PURPOSE: Modic changes (MCs) have been suggested to be a diagnostic subgroup of low back pain (LBP). However, the clinical implications of MCs remain unclear. For this reason, the aims of this study were to investigate how MCs developed over a 14-month period and if changes in the size and/or the pathological type of MCs were associated with changes in clinical symptoms in a cohort of patients with persistent LBP and MCs. METHODS: Information on LBP intensity and detailed information from MRI on the presence, type and size of MCs was collected at baseline and follow-up. Changes in type (Type I, II, III and mixed types) and size of MCs were quantified at both time points according to a standardised evaluation protocol. The associations between change in type, change in size and change in LBP intensity were calculated using odds ratios (ORs). RESULTS: Approximately 40 % of the MCs followed the expected developmental path from Type I (here Type I or I/II) to Type II (here Type II or II/III) or Type I to Type I/II. In general, the bigger the size of the MC at baseline, the more likely it was that it remained unchanged in size after 14 months. Patients who had MC Type I at both baseline and 14-month follow-up were less likely to experience an improvement in their LBP intensity as compared to patients who did not have Type I changes at both time points (OR 7.2, CI 1.3-37). There was no association between change in size of MCs Type I and change in LBP intensity. CONCLUSIONS: The presence of MCs Type I at both baseline and follow-up is associated with a poor outcome in patients with persistent LBP and MCs.

U2 - 10.1007/s00586-012-2309-9

DO - 10.1007/s00586-012-2309-9

M3 - Journal article

VL - 21

SP - 2271

EP - 2279

JO - European Spine Journal

JF - European Spine Journal

SN - 0940-6719

IS - 11

ER -