OPEN IN READ APP
JOURNAL ARTICLE

Modic Changes are not Associated with Long-Term Pain and Disability - A Cohort Study With 13-Year Follow-up

Peter Muhareb Udby, Tom Bendix, Søren Ohrt-Nissen, Michael Ruud Lassen, Joan Solgaard Sørensen, Stig Brorson, Leah Y Carreon, Mikkel Østerheden Andersen
Spine 2019 March 26
30985571

STUDY DESIGN: A comparative cohort study with 13-year follow-up.

OBJECTIVE: To assess whether Modic Changes (MCs) are associated with long-term physical disability, back pain and sick leave.

SUMMARY OF BACKGROUND DATA: Previous studies have shown a conflicting association of low back pain (LBP) with MCs and disc degeneration. The long-term prognosis of patients with MCs is unclear.

METHODS: In 2004-2005, patients aged 18-60 with daily LBP were enrolled in an RCT study and lumbar MRI was performed. Patients completed numeric rating scales (NRS, 0-10) for LBP and leg pain (LP), Roland-Morris Disability Questionnaire (RMDQ), LBP Rating Scale for activity limitations (RS, 0-30), Inflammatory pain pattern (IPP) and sick leave days due to LBP at baseline and 13-years after the MRI. Patients were stratified based on the presence (+MC) or absence (-MC) of MCs on the MRI.

RESULTS: Of 204 cases with baseline MRI, 170 (83%) were available for follow-up; 67 (39%) with MCs and 103 (61%) without MCs. Demographics, smoking status, BMI, use of antibiotics, LBP, LP and IPP scores at baseline and at 13-year follow-up were similar between the two groups. Also, baseline RMDQ was similar between the +MC and -MC groups. At 13 years, the RMDQ score was statistically significant better in the +MC group (7.4) compared to the -MC group (9.6, p = 0.024). Sick leave days due to LBP were similar at baseline but less in the +MC group (9.0) compared to the -MC group (22.9 days, p = 0.003) at 13 years.

CONCLUSION: MCs were not found to be negatively associated with long-term pain, disability or sick leave. Rather, the study found that LBP patients with MCs had significantly less disability and sick-leave at long-term follow-up. We encourage further studies to elucidate these findings.

LEVEL OF EVIDENCE: 2.

Comments

You need to log in or sign up for an account to be able to comment.

No comments yet, be the first to post one!

Related Papers

Available on the App Store

Available on the Play Store
Remove bar
Read by QxMD icon Read
30985571
×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"