Association of Modic change types and their short tau inversion recovery signals with clinical characteristics- a cross sectional study of chronic low back pain patients in the AIM-study.
Adult
Anti-Bacterial Agents
/ administration & dosage
Bone Marrow
/ diagnostic imaging
Chronic Pain
/ diagnostic imaging
Cross-Sectional Studies
Double-Blind Method
Female
Humans
Intervertebral Disc Displacement
/ diagnostic imaging
Low Back Pain
/ diagnostic imaging
Lumbar Vertebrae
/ diagnostic imaging
Magnetic Resonance Imaging
/ methods
Male
Middle Aged
Norway
Pain Measurement
Surveys and Questionnaires
Time Factors
Treatment Outcome
Back pain intensity
Bone marrow edema
Clinical characteristics
Diagnostic accuracy
Low back pain
Magnetic resonance image
Modic changes
Short tau inversion recovery
Springing test
Journal
BMC musculoskeletal disorders
ISSN: 1471-2474
Titre abrégé: BMC Musculoskelet Disord
Pays: England
ID NLM: 100968565
Informations de publication
Date de publication:
10 Jun 2020
10 Jun 2020
Historique:
received:
20
02
2020
accepted:
29
05
2020
entrez:
12
6
2020
pubmed:
12
6
2020
medline:
16
3
2021
Statut:
epublish
Résumé
Modic Changes (MCs, magnetic resonance imaging (MRI) signal changes in the vertebral bone marrow extending from the vertebral endplate) may represent a subgroup of nonspecific chronic low back pain that could benefit from a specific management. The primary aim was to compare clinical characteristics between patients with type 1 versus type 2 MCs. The secondary aim was to explore associations between clinical characteristics and MC related short tau inversion recovery (STIR) signals. This cross-sectional study used baseline data prospectively collected between 2015 and 2017 on the 180 patients included in the AIM-study (Antibiotics In Modic changes), a randomized controlled trial in a Norwegian hospital out-patient setting of patients with chronic low back pain, a lumbar disc herniation within the last 2 years, low back pain intensity score ≥ 5 (on a 0-10 scale) and current type 1 or type 2 MCs at the previously herniated lumbar disc level. We used prespecified clinical characteristics including self-report measures, physiologic measures and functional measures from clinical history and examination. The diagnostic accuracy of various clinical characteristics to discriminate between patients with type 1 MCs (with or without additional type 2 MCs) and patents with type 2 MCs only (not type 1) were assessed by calculating the area under the receiver-operating curve. We assessed the correlations of clinical characteristics with details of MC related STIR signal increase. No clinical characteristic differed between patients with type 1 (n = 118) versus type 2 (but not type 1) (n = 62) MCs. The clinical characteristics showed no/minor differences or no/weak correlations with MC related STIR signal increase. Patients with a positive Springing test (at any lumbar level) had slightly less volume of STIR signal increase than those with a negative test (mean difference 1.3 on a 0-48 scale, 95% CI 0.3 to 2.3). Clinical characteristics were similar for patients with type 1 MCs and patients with type 2 MCs, and showed no clinically relevant correlations with MC related STIR signal increase. ClinicalTrials.gov NCT02323412, First registered 23 December 2014.
Sections du résumé
BACKGROUND
BACKGROUND
Modic Changes (MCs, magnetic resonance imaging (MRI) signal changes in the vertebral bone marrow extending from the vertebral endplate) may represent a subgroup of nonspecific chronic low back pain that could benefit from a specific management. The primary aim was to compare clinical characteristics between patients with type 1 versus type 2 MCs. The secondary aim was to explore associations between clinical characteristics and MC related short tau inversion recovery (STIR) signals.
METHODS
METHODS
This cross-sectional study used baseline data prospectively collected between 2015 and 2017 on the 180 patients included in the AIM-study (Antibiotics In Modic changes), a randomized controlled trial in a Norwegian hospital out-patient setting of patients with chronic low back pain, a lumbar disc herniation within the last 2 years, low back pain intensity score ≥ 5 (on a 0-10 scale) and current type 1 or type 2 MCs at the previously herniated lumbar disc level. We used prespecified clinical characteristics including self-report measures, physiologic measures and functional measures from clinical history and examination. The diagnostic accuracy of various clinical characteristics to discriminate between patients with type 1 MCs (with or without additional type 2 MCs) and patents with type 2 MCs only (not type 1) were assessed by calculating the area under the receiver-operating curve. We assessed the correlations of clinical characteristics with details of MC related STIR signal increase.
RESULTS
RESULTS
No clinical characteristic differed between patients with type 1 (n = 118) versus type 2 (but not type 1) (n = 62) MCs. The clinical characteristics showed no/minor differences or no/weak correlations with MC related STIR signal increase. Patients with a positive Springing test (at any lumbar level) had slightly less volume of STIR signal increase than those with a negative test (mean difference 1.3 on a 0-48 scale, 95% CI 0.3 to 2.3).
CONCLUSION
CONCLUSIONS
Clinical characteristics were similar for patients with type 1 MCs and patients with type 2 MCs, and showed no clinically relevant correlations with MC related STIR signal increase.
TRIAL REGISTRATION
BACKGROUND
ClinicalTrials.gov NCT02323412, First registered 23 December 2014.
Identifiants
pubmed: 32522268
doi: 10.1186/s12891-020-03381-4
pii: 10.1186/s12891-020-03381-4
pmc: PMC7285575
doi:
Substances chimiques
Anti-Bacterial Agents
0
Banques de données
ClinicalTrials.gov
['NCT02323412']
Types de publication
Clinical Trial, Phase III
Journal Article
Multicenter Study
Randomized Controlled Trial
Langues
eng
Sous-ensembles de citation
IM
Pagination
368Subventions
Organisme : Helse Sør-Øst RHF
ID : 2015090
Organisme : Helse Vest
ID : 911938
Organisme : Helse Vest
ID : 911891
Investigateurs
Audny Anke
(A)
Maja Wilhelmsen
(M)
Terese Fors
(T)
Guro Kjos
(G)
Ida Beate Østhus
(IB)
Britt Elin Lurud
(BE)
Fredrik Granvigen
(F)
Hege Andersen
(H)
Øystein Petter Nygaard
(ØP)
Vidar Rao
(V)
Siv Krüger Claussen
(SK)
Erling Andersen
(E)
Anne Froholdt
(A)
Sigrun Randen
(S)
Hilde Presberg
(H)
Monica Wigemyr
(M)
Linda Margareth Pedersen
(LM)
Bendik Slagsvold Winsvold
(BS)
Mads Peder Rolfsen
(MP)
Christian Helllum
(C)
Karianne Wiger Gammelsrud
(KW)
Maria Dehli Vigeland
(MD)
Benedicte Alexandra Lie
(BA)
Siri Tennebø Flåm
(ST)
Magnus Dehli Vigeland
(MD)
Marianne Thorsø
(M)
Knut Morten Huneide
(KM)
Veronica Sørensen
(V)
Olav Lutro
(O)
Thor Einar Holmgard
(TE)
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