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- Title
Association of Modic change types and their short tau inversion recovery signals with clinical characteristics- a cross sectional study of chronic low back pain patients in the AIM-study.
- Authors
Bråten, Lars Christian Haugli; Schistad, Elina Iordanova; Espeland, Ansgar; Kristoffersen, Per Martin; Haugen, Anne Julsrud; Marchand, Gunn Hege; Vetti, Nils; Pripp, Are Hugo; Kadar, Thomas Istvan; Skouen, Jan Sture; Grotle, Margreth; Grøvle, Lars; Zwart, John-Anker; Brox, Jens Ivar; Storheim, Kjersti; The AIM-study group; Anke, Audny; Wilhelmsen, Maja; Fors, Terese; Kjos, Guro
- Abstract
<bold>Background: </bold>Modic 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.<bold>Methods: </bold>This 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.<bold>Results: </bold>No 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).<bold>Conclusion: </bold>Clinical 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.<bold>Trial Registration: </bold>ClinicalTrials.gov NCT02323412, First registered 23 December 2014.
- Subjects
LUMBAR pain; MAGNETIC resonance imaging; BONE marrow; RANDOMIZED controlled trials
- Publication
BMC Musculoskeletal Disorders, 2020, Vol 21, Issue 1, p1
- ISSN
1471-2474
- Publication type
journal article
- DOI
10.1186/s12891-020-03381-4