Modic I changes size increase from supine to standing MRI correlates with increase in pain intensity in standing position: uncovering the "biomechanical stress" and "active discopathy" theories in low back pain.
Adult
Aged
Female
Humans
Intervertebral Disc
/ diagnostic imaging
Intervertebral Disc Degeneration
/ diagnostic imaging
Low Back Pain
/ physiopathology
Lumbar Vertebrae
/ diagnostic imaging
Magnetic Resonance Imaging
Male
Middle Aged
Standing Position
Supine Position
/ physiology
Visual Analog Scale
Weight-Bearing
/ physiology
Low back pain
Modic changes
Weight-bearing MRI
Journal
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
ISSN: 1432-0932
Titre abrégé: Eur Spine J
Pays: Germany
ID NLM: 9301980
Informations de publication
Date de publication:
05 2019
05 2019
Historique:
received:
10
06
2018
accepted:
14
03
2019
revised:
22
02
2019
pubmed:
16
4
2019
medline:
9
7
2020
entrez:
16
4
2019
Statut:
ppublish
Résumé
To evaluate the relationship between degenerative disc, endplate Modic changes (MC) type I, and pain during upright weight-bearing MRI scan of the lumbar spine in a cohort of patients with non-specific low back pain. We evaluated 38 patients with non-specific low back pain and MRI evidence of Modic I vertebral changes. The patients were evaluated in a standard and upright weight-bearing position using a dedicated MR unit. The extent of endplate MC type I, intervertebral disc height at the involved level, and degree of degeneration in the same intervertebral disc were compared. Pain was assessed through the VAS questionnaire. In the upright position, the area of Modic I changes increased in 26 patients (68.4%, p ≤ 0.001) compared to the supine position. In the upright position, reduction in the disc height was found in 35 patients (92.1%). Correlation analysis showed moderate negative correlation (ρ = - 0.45) between intervertebral disc height and increase in the area of Modic I changes, and weak positive correlation (ρ = 0.12) between Pfirrmann grade and increase in the area of Modic I changes. At clinical evaluation, 30 patients (78.9%) reported worsening of low back pain standing in the upright position. Increase in VAS values on the upright position correlated significantly (ρ = 0.34) with an increase in the area of Modic I changes. Our results showed the modifications of Modic I changes under loading, with MRI evidence of increased MC area extent in the upright position and correlation between Modic changes extension increase and increase in pain in the standing position. Weight-bearing MRI scans represent a valuable complement to standard sequences since they provide the radiologist with additional diagnostic information about low back pain. These slides can be retrieved from Electronic Supplementary Material.
Identifiants
pubmed: 30982938
doi: 10.1007/s00586-019-05974-7
pii: 10.1007/s00586-019-05974-7
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
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