Prevalence and Factors Associated with Modic Changes of Lumbosacral Spine in Nepalese Patients with Chronic Low Back Pain

Background/Aim. Low back pain is one of the most common painful conditions in the modern age. Therefore, it is very important to establish the most effective protocol for the treatment of this condition. The aim of this study was to find out if fluoroscopically, guided epidural procainecorticosteroid injection is effective in the treatment of degenerative chronic low back pain. Methods. This prospective cohort study was performed in the Military Medical Academy from September 2005 to June 2006 and included 60 patients of both sexes, 34-85 years of age. Degenerative changes of lumbosacral spine were determined by magnetic resonance imaging. The intensity of low back pain was evaluated by subjective (Roland's scale) and objective parameter (Lazarevic sign). Epidural procaine-corticosteroid injection was applied in the patients with low back pain not responding to conservative therapy. After the application of injection, effects of the therapy were followed up. Results. In 92% of the patients there was a reduction of pain intensity for three months, in 4.8% a reduction for a month, but after another injection they felt pain reduction for the next three months. One patient (2.3%) had pain reduction for one month. Conclusion. In the treatment of degenerative chronic low back pain, not responding to conservative therapy with nonsteroidal anti-inflammatory drugs, epidural procaine-corticosteroid injection have a satisfactory short-term as well as a long-term analgesic effect.

Download Full-text

Investigating a Possible Link between MRI Findings of Lumbar Disc Degeneration and Modic Changes in the Patients with Chronic Low Back Pain

Orthopedic Research Online Journal ◽

10.31031/oproj.2018.04.000598 ◽

2018 ◽

Vol 4 (5) ◽

Author(s):

Farzad Omidi Kashani

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Disc Degeneration ◽

Chronic Low Back Pain ◽

Lumbar Disc ◽

Modic Changes ◽

Low Back ◽

Lumbar Disc Degeneration ◽

Mri Findings

Download Full-text

The effect of infliximab in patients with chronic low back pain and Modic changes (the BackToBasic study): study protocol of a randomized, double blind, placebo-controlled, multicenter trial

BMC Musculoskeletal Disorders ◽

10.1186/s12891-020-03720-5 ◽

2020 ◽

Vol 21 (1) ◽

Author(s):

Elisabeth Gjefsen ◽

Lars Christian Haugli Bråten ◽

Guro Løvik Goll ◽

Monica Wigemyr ◽

Nils Bolstad ◽

...

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Chronic Low Back Pain ◽

Treatment Strategy ◽

Treatment Options ◽

Modic Changes ◽

Low Back ◽

Double Blind ◽

Link Type

Abstract Background Low back pain is common and a significant number of patients experience chronic low back pain. Current treatment options offer small to moderate effects. Patients with vertebral bone marrow lesions visualized as Modic changes on magnetic resonance imaging may represent a subgroup within the low back pain population. There is evidence for inflammatory mediators being involved in development of Modic changes; hence, suppression of inflammation could be a treatment strategy for these patients. This study examines the effect of anti-inflammatory treatment with the TNF-α inhibitor infliximab in patients with chronic low back pain and Modic changes. Methods/design The BackToBasic trial is a multicenter, double blind, randomized controlled trial conducted at six hospitals in Norway, comparing intravenous infusions with infliximab with placebo. One hundred twenty-six patients aged 18–65 with chronic low back pain and type 1 Modic changes will be recruited from secondary care outpatients’ clinics. The primary outcome is back pain-specific disability at day 154 (5 months). The study is designed to detect a difference in change of 10 (SD 18) in the Oswestry Disability Index at day 154/ 5 months. The study also aims to refine MRI-assessment, investigate safety and cost-effectiveness and explore the underlying biological mechanisms of Modic changes. Discussion Finding treatments that target underlying mechanisms could pose new treatment options for patients with low back pain. Suppression of inflammation could be a treatment strategy for patients with low back pain and Modic changes. This paper presents the design of the BackToBasic study, where we will assess the effect of an anti-inflammatory treatment versus placebo in patients with chronic low back pain and type 1 Modic changes. The study is registered at ClinicalTrials.gov under the identifier NCT03704363. The EudraCT Number: 2017–004861-29.

Download Full-text