Association between changes in lumbar Modic changes and low back symptoms over a two-year period.

Area of Science:

• Radiology
• Orthopedics
• Pain Medicine

Background:

• The relationship between Modic changes (MC) and low back pain (LBP) remains incompletely understood.
• This study aimed to clarify the association between the extent of Type 1 (M1) and Type 2 (M2) Modic changes and low back symptoms.

Purpose of the Study:

• To investigate the longitudinal association between the extent of Modic Type 1 (M1) and Type 2 (M2) changes and low back symptoms.
• To determine if changes in the extent of M1 and M2 correlate with changes in low back pain intensity and disability.

Main Methods:

• Sixty-four chronic LBP patients with M1 or mixed M1/M2 changes on MRI underwent a two-year follow-up.
• The extent of M1 and M2 was quantified using MRI measurements, assessing size and proportion within Modic changes.
• Linear regression analysis was employed to associate changes in M1/M2 extent with changes in LBP intensity and Oswestry Disability Index (ODI).

Main Results:

• At baseline, mean LBP intensity was 6.5/10 and mean ODI was 33%.
• Over two years, M1 extent changes significantly correlated positively with increases in LBP intensity (p=0.036) and ODI (p=0.017).
• After adjusting for baseline factors, M1 extent changes remained significantly associated with ODI changes (p=0.003), while M2 extent changes showed no significant association.

Conclusions:

• The extent of Modic Type 1 changes is a significant predictor of changes in low back pain and disability.
• Modic Type 2 changes do not appear to be significantly associated with longitudinal changes in low back symptoms.