Correlation of Modic Changes with Sagittal Lumbopelvic Parameters

OBJECTIVEThe aim of this study was to evaluate the effect of lumbar sacralization on the level of vertebral slip and disc degeneration in patients with L4 spondylolysis.METHODSThe authors analyzed data from 102 cases in which patients underwent surgical treatment for L4 spondylolysis and spondylolisthesis at their institution between March 2007 and September 2016. Lumbar sacralization was characterized by the presence of pseudarthrosis and/or bony fusion between the L5 transverse process and sacrum, and the type of lumbosacral transitional vertebra (LSTV) was evaluated with the Castellvi classification. The amount of vertebral slippage was measured using the Taillard technique and Meyerding grade. Degeneration of the L4–5 segment was quantified using the Pfirrmann and Modic classifications. Patients were divided into 2 groups based on the presence or absence of sacralization, and the amount of vertebral slip and degeneration of the L4–5 segment was compared between groups.RESULTSLumbar sacralization was present in 37 (36%) of 102 patients with L4 spondylolysis. The LSTV was type IIa in 10 cases, type IIb in 7, type IIIa in 2, and type IIIb in 18. The levels of vertebral slip and disc degeneration in the group of patients with sacralization were significantly greater than in the group without sacralization. No significant difference was found between the 2 groups with respect to Modic changes.CONCLUSIONSThe increased stability between a sacralized L5 and the sacrum may predispose the L4–5 segment to greater instability and disc degeneration in patients with L4 spondylolysis.

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Lumbar Disc Herniation and Preoperative Modic Changes: A Prospective Analysis of the Clinical Outcomes After Microdiscectomy

Global Spine Journal ◽

10.1177/2192568220976089 ◽

2021 ◽

pp. 219256822097608

Author(s):

Dinesh Kumarasamy ◽

Shanmuganathan Rajasekaran ◽

Sri Vijay Anand K. S ◽

Dilip Chand Raja Soundararajan ◽

Ajoy Prasad Shetty T ◽

...

Keyword(s):

Patient Satisfaction ◽

Back Pain ◽

Clinical Outcomes ◽

Lumbar Disc Herniation ◽

Disc Herniation ◽

Rating Scale ◽

Lumbar Disc ◽

Modic Changes ◽

P Value ◽

Functional Scores

Study design: Prospective comparative cohort study. Objectives: The study aims to elucidate the relationship between Modic endplate changes and clinical outcomes after a lumbar microdiscectomy. Methods: Consecutive patients undergoing microdiscectomy for lumbar disc herniation (LDH) were prospectively studied. Pre-operative clinical and radiological parameters were recorded. The pain was assessed by Numeric pain rating scale (NPRS), and functional assessment by Oswestry Disability Index (ODI). Minimal clinically important difference (MCID) in outcome was calculated for both the groups. Complications related to surgery were studied. Follow-up was done at 6 weeks, 3 months, 6 months and 1 year. Mac Nab criteria were used to assess patient satisfaction at 1 year. Results: Out of 309 patients, 86 had Modic changes, and 223 had no Modic changes. Both groups had similar back pain (p-value: 0.07) and functional scores (p-value: 0.85) pre-operatively. Postoperatively patients with Modic changes had poorer back pain and ODI scores in the third month, sixth month and 1 year (p-value: 0.001). However, MCID between the groups were not significant (p-value: 0.18 for back pain and 0.58 for ODI scores). Mac Nab criteria at 1 year were worse in Modic patients (p-value: 0.001). No difference was noted among Modic types in the pre-operative and postoperative pain and functional outcomes. Four patients in Modic group (4.7%) and one patient in the non-Modic group (0.5%) developed postoperative discitis (p-value: 0.009). Conclusions: Preoperative Modic changes in lumbar disc herniation is associated with less favorable back pain, functional scores and patient satisfaction in patients undergoing microdiscectomy.

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What is the Role of the Bacterium Propionibacterium acnes in Type 1 Modic Changes? A Review of the Literature

Canadian Association of Radiologists Journal ◽

10.1016/j.carj.2017.07.004 ◽

2017 ◽

Vol 68 (4) ◽

pp. 419-424 ◽

Cited By ~ 10

Author(s):

Mark Georgy ◽

Mark Stern ◽

Kieran Murphy

Keyword(s):

Randomized Controlled Trial ◽

Propionibacterium Acnes ◽

Controlled Trial ◽

Modic Changes ◽

Low Back ◽

Review Of The Literature ◽

Disc Disease ◽

Randomized Controlled

This review presents a summary of the pathology and epidemiology of Modic changes and the possible role of Propionibacterium acnes. This information is followed by a synthesis of the most recent clinical research involved in culturing the discs of patients with degenerative disc disease for the presence of bacteria. We also discuss a randomized controlled trial that investigates the effects of antibiotics on patients with chronic low back pain and type 1 Modic changes. We conclude with a brief discussion of the difficulties involved in this research and the significance of the findings.

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Is the development of Modic changes associated with clinical symptoms? A 14-month cohort study with MRI

European Spine Journal ◽

10.1007/s00586-012-2309-9 ◽

2012 ◽

Vol 21 (11) ◽

pp. 2271-2279 ◽

Cited By ~ 46

Author(s):

Rikke K. Jensen ◽

Charlotte Leboeuf-Yde ◽

Niels Wedderkopp ◽

Joan S. Sorensen ◽

Tue S. Jensen ◽

...

Keyword(s):

Cohort Study ◽

Clinical Symptoms ◽

Modic Changes

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Is the Distribution Pattern of Modic Changes in Vertebral End-plates Associated With the Severity of Intervertebral Disc Degeneration?: A Cross-sectional Analysis of 527 Caucasians

World Neurosurgery ◽

10.1016/j.wneu.2021.02.128 ◽

2021 ◽

Author(s):

Emel Ece Özcan-Ekşi ◽

Ali Yayla ◽

Ömer Orhun ◽

Veli Umut Turgut ◽

Havva Nur Arslan ◽

...

Keyword(s):

Intervertebral Disc ◽

Distribution Pattern ◽

Disc Degeneration ◽

Intervertebral Disc Degeneration ◽

Modic Changes ◽

Cross Sectional ◽

Cross Sectional Analysis ◽

Sectional Analysis

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Preoperative Modic changes are related to axial symptoms after anterior cervical discectomy and fusion

Journal of Pain Research ◽

10.2147/jpr.s172953 ◽

2018 ◽

Vol Volume 11 ◽

pp. 2617-2623 ◽

Cited By ~ 3

Author(s):

Jiaming Zhou ◽

Liandong Li ◽

Tengshuai Li ◽

Yuan Xue

Keyword(s):

Modic Changes ◽

Anterior Cervical Discectomy ◽

Cervical Discectomy ◽

Axial Symptoms

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Intervertebral disc vacuum phenomenon is associated with Modic changes in the adjacent endplate: implications for discogenic back pain

10.21203/rs.3.rs-38301/v1 ◽

2020 ◽

Author(s):

Junhui Liu ◽

Yufeng Xiang ◽

Zhi Shan ◽

Shunwu Fan ◽

Fengdong Zhao

Keyword(s):

Back Pain ◽

Lumbar Disc ◽

Intervertebral Discs ◽

Modic Changes ◽

Type I ◽

Type Ii ◽

Vacuum Phenomenon ◽

Lower Lumbar Spine ◽

Lumbar Degenerative Diseases ◽

Lower Lumbar

Abstract Background Back pain often arises from degenerative changes in lumbar intervertebral discs and their adjacent endplates. A painful endplate is not easy to identify in patients, but could possibly be revealed by inflammatory-like ‘Modic’ changes and by a ‘vacuum phenomenon’ within the disc. We hypothesize that Modic changes and a VP often co-exist in those lumbar levels most closely associated with back pain Methods We scanned 1023 consecutive inpatients of the Department of Orthopaedics from 2015 August to 2018 August, all patients suffered from lumbar degenerative diseases, whether the patients had back pain or not were evaluated, and the prevalence and location of vacuum phenomenon(VP) and Modic changes were compared at each spinal level. Results 5115 discs were studied from 1023 patients. The number of discs showed to have a VP was 430 using CT, of the 430 discs with a CT-diagnosed VP, 116 were L4-5, and 171 were L5-S1. 522 of the 5115 discs exhibited Modic changes, with prevalence of type I, type II and type III Modic changes being 1.6%, 8.2% and 0.4% respectively. Modic changes usually occurred adjacent to L4-5 discs or L5-S1 discs. The prevalence of back pain was higher in the VP group than no-VP group, VP were significantly associated with Modic changes Type II at L4/5 and at L5/S1. Conclusion VP are closely associated with back pain and Modic changes in the lower lumbar spine. Further investigations may be warranted when radiographs or CT identify a VP in a lumbar disc.

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