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The natural history of Modic changes in a community-based cohort

Citation

Teichtahl, AJ and Finnin, MA and Wang, Y and Wluka, AE and Urquhart, DM and O'Sullivan, R and Jones, G and Cicuttini, FM, The natural history of Modic changes in a community-based cohort, Joint Bone Spine, 84, (2) pp. 197-202. ISSN 1297-319X (2017) [Refereed Article]

Copyright Statement

Copyright 2016 Société française de rhumatologie

DOI: doi:10.1016/j.jbspin.2016.03.011

Abstract

BACKGROUND: Vertebral endplate (Modic) lesions are gaining interest, with varied phenotypes recognised to have distinct clinical and histological correlates. Nevertheless, the natural history of these lesions is unclear. This study examined the natural history of Modic changes and their potential relationship to the intervertebral disc.

METHODS: Seventy-two community-based adults not selected for low back pain had lumbar spine magnetic resonance imaging (MRI) performed at baseline (2012) and approximately 2 years later to assess Modic lesions. Fifty-six participants completed the study. Intervertebral disc pathology was assessed by disc height and the Pfirrmann grading system at baseline.

RESULTS: At baseline, 6 Modic type 1 lesions were present in 3 (4.2%) participants. At follow-up, 4 persisted, 2 changed to a Modic type 2 lesion, and there were 4 incident lesions. Only 1 participant (1.4%) had a baseline Modic type 3 lesion, which persisted at follow-up, with one further incident lesion. Modic type 2 lesions were most common (n=47, in 20 of 72 [27.8%] participants). Resolution of Modic type 2 lesions was uncommon (n=1, with 2 changing to a type 1 lesion). 18 incident lesions occurred in 7 (12.5%) participants, with most occurring both sides of the intervertebral disc. A reduction in the average baseline disc height was associated with an increased risk for type 2 incident lesions (OR 1.9, 95% CI 1.1 to 3.3, P=0.03). Similarly, severe baseline disc degeneration at L3/4, L4/5 and L5/S1 was associated with an increased risk for type 2 incident lesions (all P≤0.05).

CONCLUSION: This longitudinal study has demonstrated that Modic type 2 are the most common of the Modic lesions in community-based adults and while resolution of these lesions is uncommon, incident disease develops on both sides of the intervertebral disc in the setting of severe disc degeneration. These results suggest that type 2 Modic changes are a sequel of disc degeneration.

Item Details

Item Type:Refereed Article
Keywords:Lumbar spine, Intervertebral disc, Modic
Research Division:Medical and Health Sciences
Research Group:Clinical Sciences
Research Field:Rheumatology and Arthritis
Objective Division:Health
Objective Group:Clinical Health (Organs, Diseases and Abnormal Conditions)
Objective Field:Skeletal System and Disorders (incl. Arthritis)
Author:Jones, G (Professor Graeme Jones)
ID Code:114853
Year Published:2017 (online first 2016)
Deposited By:Menzies Institute for Medical Research
Deposited On:2017-03-01
Last Modified:2017-11-01
Downloads:0

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