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Modic changes following lumbar disc herniation.

Hanne B Albert1, Claus Manniche

  • 1The Back Research Center, Part of Clinical Locomotion Science, University of Southern Denmark, Lindevej 5, 5750 Ringe, Denmark. haal@shf.fyns-amt.dk

European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
|March 6, 2007
PubMed
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Modic changes, particularly type 1, are strongly associated with non-specific low back pain (LBP). A previous disc herniation significantly increases the risk of developing these changes over the following year.

Area of Science:

  • Orthopedics
  • Radiology
  • Pain Medicine

Background:

  • Low back pain (LBP) diagnosis is often challenging, with only 20% of cases having a clear patho-anatomical cause.
  • Identifying subgroups, particularly those with a patho-anatomical basis, is crucial for effective LBP management.
  • Modic changes have been frequently linked to LBP, suggesting a potential diagnostic or prognostic role.

Purpose of the Study:

  • To determine the prevalence and development of Modic changes in patients with a history of severe sciatica.
  • To investigate the association between Modic changes and non-specific LBP, disc contour, and prior surgery.
  • To assess the predictive value of lumbar disc herniation for the development of Modic changes.

Main Methods:

  • A longitudinal cohort study involving 181 patients with radicular pain below the knee at baseline.

Related Experiment Videos

  • Baseline and 14-month follow-up assessments included physical examination and magnetic resonance imaging (MRI).
  • Analysis focused on Modic changes (type 1 and type 2), LBP, disc herniation, and surgical history.

    • Main Results:

    • Prevalence of Modic changes type 1 increased from 9% to 29% over 14 months.
    • A significant association was found between Modic changes and non-specific LBP at follow-up.
    • Modic changes type 1 showed a stronger association with non-specific LBP than type 2.
    • New Modic changes were closely related to the level of previous disc herniation, indicating it as a risk factor.

    Conclusions:

    • Modic changes are strongly associated with non-specific LBP, particularly type 1.
    • A previous lumbar disc herniation is a significant risk factor for developing Modic changes within a year.
    • Further research into Modic changes may aid in stratifying LBP patients for targeted interventions.