A Prospective, 3-year Longitudinal Study of Modic Changes of the Lumbar Spine in a Population-based Cohort: The Wakayama Spine Study.
Journal
Spine
ISSN: 1528-1159
Titre abrégé: Spine (Phila Pa 1976)
Pays: United States
ID NLM: 7610646
Informations de publication
Date de publication:
15 Mar 2022
15 Mar 2022
Historique:
entrez:
25
2
2022
pubmed:
26
2
2022
medline:
3
3
2022
Statut:
ppublish
Résumé
Large-scale, prospective, population-based, longitudinal observational study. The aim of this study was to investigate the rate of incidence, transformation, and reverse transformation of Modic changes (MCs) using T1-weighted (T1W) and T2-weighted (T2W) lumbar magnetic resonance images (MRI) over a 3-year period. Although MCs in populational study are considered significant, existing epidemiological evidence is based on cross-sectional studies only. Overall, 678 subjects (208 men, 470 women, mean age 62.1 ± 12.8 years in 2013) in both 2013 and 2016 surveys were included. The rate of change in Modic Type I (T1W: low-intensity, T2W: high-intensity), Type II (T1W: high, T2W: high), and Type III (T1W: low, T2W: low) at five endplates was analyzed over a 3-year period. An incidence of MC at each level and in the lumbar region was defined as no MC at baseline with signal changes at follow-up. Transformation was defined as Type I or II MC at baseline with conversion at follow-up Type II from Type I or Type III MC from Type I and II. Furthermore, reverse transformation was defined as Type I, II, or III MC at baseline, with at least one endplate showing a reversion in Modic type (no MC for baseline Type I; no MC and Type I for baseline Type II; no MC, Type I or Type II for baseline Type III) at follow-up. Overall, 3390 endplates were included. For 3 years, the incidence, transformation, and reverse transformation of MCs were seen in 395 (11.7%), 84 (2.5%), and 11 (0.3%) endplates, respectively. The highest levels of incidence, transformation, and reverse transformation were at L2/3 (96 [14.2%] endplates), L5/S1 (32 [4.7%] endplates), and L2/3 (5 [0.7%] endplates), respectively. This study revealed a high incidence of MCs at the upper lumbar levels and transformation at the lower lumbar levels. Reverse transformation of MCs occurs but are rare.Level of Evidence: 2.
Sections du résumé
STUDY DESIGN
METHODS
Large-scale, prospective, population-based, longitudinal observational study.
OBJECTIVE
OBJECTIVE
The aim of this study was to investigate the rate of incidence, transformation, and reverse transformation of Modic changes (MCs) using T1-weighted (T1W) and T2-weighted (T2W) lumbar magnetic resonance images (MRI) over a 3-year period.
SUMMARY OF BACKGROUND DATA
BACKGROUND
Although MCs in populational study are considered significant, existing epidemiological evidence is based on cross-sectional studies only.
METHODS
METHODS
Overall, 678 subjects (208 men, 470 women, mean age 62.1 ± 12.8 years in 2013) in both 2013 and 2016 surveys were included. The rate of change in Modic Type I (T1W: low-intensity, T2W: high-intensity), Type II (T1W: high, T2W: high), and Type III (T1W: low, T2W: low) at five endplates was analyzed over a 3-year period. An incidence of MC at each level and in the lumbar region was defined as no MC at baseline with signal changes at follow-up. Transformation was defined as Type I or II MC at baseline with conversion at follow-up Type II from Type I or Type III MC from Type I and II. Furthermore, reverse transformation was defined as Type I, II, or III MC at baseline, with at least one endplate showing a reversion in Modic type (no MC for baseline Type I; no MC and Type I for baseline Type II; no MC, Type I or Type II for baseline Type III) at follow-up.
RESULTS
RESULTS
Overall, 3390 endplates were included. For 3 years, the incidence, transformation, and reverse transformation of MCs were seen in 395 (11.7%), 84 (2.5%), and 11 (0.3%) endplates, respectively. The highest levels of incidence, transformation, and reverse transformation were at L2/3 (96 [14.2%] endplates), L5/S1 (32 [4.7%] endplates), and L2/3 (5 [0.7%] endplates), respectively.
CONCLUSION
CONCLUSIONS
This study revealed a high incidence of MCs at the upper lumbar levels and transformation at the lower lumbar levels. Reverse transformation of MCs occurs but are rare.Level of Evidence: 2.
Identifiants
pubmed: 35213525
doi: 10.1097/BRS.0000000000004301
pii: 00007632-202203150-00013
doi:
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
490-497Informations de copyright
Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.
Références
Murray CJL, Barber RY, et al. GBD 2013 DALYs and Hale Collaborators. Global, regional, and national disability-adjusted life years (DALYs) for 306 diseases and injuries and healthy life expectancy (HALE) for 188 countries, 1990-2013: quantifying the epidemiological transition. Lancet 2015; 386:2145–2191.
Vos T, Flaxman AD, Naghavi M, et al. Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: a systematic analysis for the global burden of disease study. Lancet 2012; 380:2163–2196.
Karppinen J, Shen FH, Luk KD, et al. Management of degenerative disk disease and chronic low back pain. Orthop Clin North Am 2011; 42:513–528.
Samartzis D, Borthakur A, Belfer I, et al. Novel diagnostic and therapeutic methods for intervertebral disc degeneration and low back pain. Spine J 2015; 15:1919–1932.
Boden SD, Davis DO, Dina TS, et al. Abnormal magnetic-resonance scans of the lumbar spine in asymptomatic subjects. A prospective investigation. J Bone Joint Surg Am 1990; 72:403–408.
Brinjikji W, Diehn FE, Jarvik JG, et al. MRI findings of disc degeneration are more prevalent in adults with low back pain than in asymptomatic controls: a systematic review and meta- analysis. AJNR Am J Neuroradiol 2015; 36:2394–2399.
Teraguchi M, Cheung JPY, Karppinen J, et al. Lumbar high- intensity zones on MRI: imaging biomarkers for severe, prolonged low back pain and sciatica in a population-based cohort. Spine J 2020; 20:1025–1034.
Maatta J, Karppinen J, Paananen M, et al. Refined phenotyping of Modic changes: potential imaging biomarkers of prolonged severe low back pain and disability. Medicine 2016; 95:e3495.
Maatta JH, Karppinen JI, Luk KD, et al. Phenotype profiling of modic changes of the lumbar spine and its association with other MRI phenotypes: a large- scale population-based study. Spine J 2015; 15:1933–1942.
Mok FP, Samartzis D, Karppinen J, et al. Modic changes of the lumbar spine: prevalence, risk factors, and association with disc degeneration and low back pain in a large-scale population-based cohort. Spine J 2016; 16:32–41.
Samartzis D, Mok FP, Karppinen J, et al. Classification of Schmorl's nodes of the lumbar spine and association with disc degeneration: a large-scale population- based MRI study. Osteoarthr Cartil 2016; 24:1753–1760.
Modic MT, Steinberg PM, Ross JS, et al. Degenerative disk disease: assessment of changes in vertebral body marrow with MR imaging. Radiology 1988; 166:193–199.
Teraguchi M, Yim R, Cheung JP, et al. The association of high-intensity zones on MRI and low back pain: a systematic review. Scoliosis Spinal Disord 2018; 13:22.
Modic MT, Masaryk TJ, Ross JS, et al. Imaging of degenerative disk disease. Radiology 1988; 168:177–186.
Andrew JT, Monica AF, Yuanyuan W, et al. The natural history of Modic changes in a community-based cohort. Joint Bone Spine 2017; 84:197–202.
Kuisma M, Karppinen J, Niinimäki J, et al. A three-year follow-up of lumbar spine endplate (Modic) changes. Spine (Phila Pa 1976) 2006; 31:1714–1718.
Mitra D, Cassar-Pullicino VN, Mccall IW. Longitudinal study of vertebral type-1 end-plate changes on MR of the lumbar spine. Eur Radiol 2004; 14:1574–1581.
Kerttula L, Luoma K, Vehmas T, et al. Modic type I change may predict rapid progressive, deforming disc degeneration: a prospective 1-year follow-up study. Eur Spine J 2012; 21:1135–1142.
Jensen RK, Leboeuf-Yde C, Wedderkopp N, et al. Is the development of modic changes associated with clinical symptoms? A 14-month cohort study with MRI. Eur Spine J 2012; 21:2271–2279.
Luoma K, Vehmas T, Gronblad M, et al. MRI follow-up of subchondral signal abnormalities in a selected group of chronic low back pain patients. Eur Spine J 2008; 17:1300–1308.
Modic MT, Ross JS. Lumbar degenerative disk disease. Radiology 2007; 245:43–61.
Jensen TS, Bendix T, Sorensen JS, et al. Characteristics and natural course of vertebral endplate signal (Modic) changes in the Danish general population. BMC Musculoskelet Disord 2009; 10:81.
Marshman LA, Trewhella M, Friesem T, et al. Reverse transformation of Modic type 2 changes to Modic type 1 changes during sustained chronic low-back pain severity. Report of two cases and review of the litterature. J Neurosurg Spine 2007; 6:152–155.
Teraguchi M, Yoshimura N, Hashizume H, et al. Prevalence and distribution of interverte-bral disc degeneration over the entire spine in a population-based cohort: the Wakayama spine study. Osteoarthr Cartil 2014; 22:104–110.
Teraguchi M, Yoshimura N, Hashizume H, et al. The association of combination of disc degeneration, end plate signal change, and schmorl node with low back pain in a large population study: the Wakayama spine study. Spine J 2015; 15:622–628.
Mera Y, Teraguchi M, Hashizume H, et al. Association between types of Modic changes in the lumbar region and low back pain in a large cohort: the Wakayama spine study. Eur Spine J 2021; 30:1011–1017.
Yoshimura N, Muraki S, Oka H, et al. Cohort profile: research on osteoarthritis/osteoporosis against disability (ROAD) study. Int J Epidemiol 2010; 39:988–995.
Yoshimura N, Muraki S, Oka H, et al. Prevalence of knee osteoarthritis, lumbar spondylosis, and osteoporosis in Japanese men and women: the research on osteoarthritis/osteoporosis against disability study. J Bone Min Metab 2009; 27:620–628.
Pfirrmann CW, Metzdorf A, Zanetti M, et al. Magnetic resonance classification of lumbar intervertebral disc degeneration. Spine (Phila Pa 1976) 2001; 26:1873–1878.
Vavken P, Ganal-Antonio AKB, Shen FH, et al. Fundamentals of clinical outcomes assessment for spinal disorders: study designs, methodologies, and analyses. Global Spine J 2015; 5:156–164.
Teraguchi M, Yoshimura N, Hashizume H, et al. Progression, incidence, and risk factors for intervertebral disc degeneration in a longitudinal population-based cohort: the Wakayama Spine Study. Osteoarthritis Cartilage 2017; 25:1122–1131.
Ohtori S, Inoue G, Ito T, et al. Tumor necrosis factor-immunoreactive cells and PGP 9.5-immunoreactive nerve fibers in vertebral endplates of patients with discogenic low back pain and Modic Type 1 or Type 2 changes on MRI. Spine (Phila Pa 1976) 2006; 31:1026–1031.