• Lars Christian Haugli Bråten, Elina Iordanova Schistad, Ansgar Espeland, Per Martin Kristoffersen, Anne Julsrud Haugen, Gunn Hege Marchand, Nils Vetti, Are Hugo Pripp, Thomas Istvan Kadar, Jan Sture Skouen, Margreth Grotle, Lars Grøvle, John-Anker Zwart, Jens Ivar Brox, Kjersti Storheim, and AIM-study group.
• Research and Communication Unit for Musculoskeletal Health(FORMI), Oslo University Hospital HF, Ullevål, Postbox 4956, Nydalen, 0424, Oslo, Norway. l.c.h.braten@studmed.uio.no.
• Bmc Musculoskel Dis. 2020 Jun 10; 21 (1): 368.

BackgroundModic Changes (MCs, magnetic resonance imaging (MRI) signal changes in the vertebral bone marrow extending from the vertebral endplate) may represent a subgroup of nonspecific chronic low back pain that could benefit from a specific management. The primary aim was to compare clinical characteristics between patients with type 1 versus type 2 MCs. The secondary aim was to explore associations between clinical characteristics and MC related short tau inversion recovery (STIR) signals.MethodsThis cross-sectional study used baseline data prospectively collected between 2015 and 2017 on the 180 patients included in the AIM-study (Antibiotics In Modic changes), a randomized controlled trial in a Norwegian hospital out-patient setting of patients with chronic low back pain, a lumbar disc herniation within the last 2 years, low back pain intensity score ≥ 5 (on a 0-10 scale) and current type 1 or type 2 MCs at the previously herniated lumbar disc level. We used prespecified clinical characteristics including self-report measures, physiologic measures and functional measures from clinical history and examination. The diagnostic accuracy of various clinical characteristics to discriminate between patients with type 1 MCs (with or without additional type 2 MCs) and patents with type 2 MCs only (not type 1) were assessed by calculating the area under the receiver-operating curve. We assessed the correlations of clinical characteristics with details of MC related STIR signal increase.ResultsNo clinical characteristic differed between patients with type 1 (n = 118) versus type 2 (but not type 1) (n = 62) MCs. The clinical characteristics showed no/minor differences or no/weak correlations with MC related STIR signal increase. Patients with a positive Springing test (at any lumbar level) had slightly less volume of STIR signal increase than those with a negative test (mean difference 1.3 on a 0-48 scale, 95% CI 0.3 to 2.3).ConclusionClinical characteristics were similar for patients with type 1 MCs and patients with type 2 MCs, and showed no clinically relevant correlations with MC related STIR signal increase.Trial RegistrationClinicalTrials.gov NCT02323412, First registered 23 December 2014.

40 keywords...

hide…