• Elina Iordanova Schistad, Ansgar Espeland, Lars Jørgen Rygh, Cecilie Røe, and Johannes Gjerstad.
• Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Ullevål, Nydalen, Postbox 4956, 0424, Oslo, Norway, uxioel@ous-hf.no.
• Skeletal Radiol. 2014 Sep 1;43(9):1271-9.

ObjectiveTo examine whether Modic changes influence pain during a 1-year follow-up in patients with lumbar radicular pain.Materials And MethodsA total of 243 patients with lumbar radicular pain due to disc herniation were recruited from two hospitals in Norway and followed up at 6 weeks, 6 months, and 12 months. On baseline lumbar magnetic resonance images, two observers independently evaluated Modic changes (types I-III; craniocaudal size 0-3). Outcomes were sensory pain (McGill Pain Questionnaire), back and leg pain (visual analogue scale, VAS). Association between Modic type and outcomes was explored with a mixed model and then by two-way analysis of variance (ANOVA) at each time point with Modic and treatment groups (surgical, n = 126; nonsurgical, n = 117) as fixed factors, adjusted for disc degeneration, age, sex, smoking, and duration of radicular pain. Modic size was also analyzed using ANOVA.ResultsPain scores had decreased significantly at 1-year follow-up. Modic type was significantly related to McGill sensory scores (mixed model: p = 0.014-0.026; ANOVA: p = 0.007 at 6 weeks), but not to VAS back pain or VAS leg pain scores. At 6 weeks, the mean McGill sensory score was higher in Modic I than in Modic II-III patients (p = 0.003) and in patients without Modic changes (p = 0.018). Modic size L1-S1 was not associated with pain outcomes.ConclusionPatients with lumbar radicular pain have a substantial pain reduction during 1-year follow-up, but Modic type I changes may imply a slower initial decrease in sensory pain.

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