• Eur Spine J · Sep 2021

    Role of growth plate (apophyseal ring fracture) in causing modic type changes in pediatric low back pain patients.

    • Hiroaki Manabe, Toshinori Sakai, Yasuyuki Omichi, Kosuke Sugiura, Masatoshi Morimoto, Fumitake Tezuka, Kazuta Yamashita, Yoichiro Takata, Toru Maeda, and Koichi Sairyo.
    • Department of Orthopedics, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15, Kuramoto-cho, Tokushima, 770-8503, Japan. s52726362@yahoo.co.jp.
    • Eur Spine J. 2021 Sep 1; 30 (9): 2565-2569.

    PurposeWe investigated the prevalence of Modic changes (MCs) and associated pathologies in pediatric patients.MethodsA total of 368 MRI obtained for 240 male and 128 female patients under the age of 18 years with complaints of low back/leg pain were retrospectively examined. All changes in signal intensity in the vertebral endplate and subchondral bone on MRI were defined as MCs. We investigated the relationship between MCs and underlying diseases, including lumbar spondylolysis/spondylolisthesis, and conditions of the growth plate in cases with MCs. The degree of disc degeneration in patients with MCs was evaluated using the Pfirrmann grading system.ResultsMCs were identified in six patients (1.6%). In five of the six patients, the signal intensity changes were localized to the anterosuperior endplate of the affected vertebra; the MCs were associated with anterior apophyseal ring fracture and an open growth plate in all these cases. Disc degeneration was classified as Pfirrmann grade I in three patients and grade II and III in one patient each. One patient had type I changes associated with grade IV disc degeneration and herniation and no sign of an open growth plate.ConclusionThe prevalence of MCs in pediatrics patients was much lower than the rates reported in adults. Most MCs were associated with an anterior apophyseal ring fracture. If Modic type changes are seen in immature vertebrae of pediatric patients, growth plate lesions such as apophyseal ring fractures should be considered.Level Of EvidenceDiagnostic: individual l cross-sectional studies with consistently applied reference standard and blinding.© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

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