Cargando…

Loading of the Spine in Low Back Pain Patients Does Not Induce MRI Changes in Modic Lesions: A Prospective Clinical Study

Modic changes (MCs) are gaining increased interest as potential generators of low back pain (LBP). The current aim was to investigate possible spinal loading effects on the MRI signal in MCs in patients with LBP. Supine lumbar MRIs were performed and immediately repeated with axial loading in 100 LB...

Descripción completa

Detalles Bibliográficos
Autores principales: Hebelka, Hanna, Brisby, Helena, Erkmar, Alfred, Lagerstrand, Kerstin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9406333/
https://www.ncbi.nlm.nih.gov/pubmed/36010166
http://dx.doi.org/10.3390/diagnostics12081815
_version_ 1784774095038054400
author Hebelka, Hanna
Brisby, Helena
Erkmar, Alfred
Lagerstrand, Kerstin
author_facet Hebelka, Hanna
Brisby, Helena
Erkmar, Alfred
Lagerstrand, Kerstin
author_sort Hebelka, Hanna
collection PubMed
description Modic changes (MCs) are gaining increased interest as potential generators of low back pain (LBP). The current aim was to investigate possible spinal loading effects on the MRI signal in MCs in patients with LBP. Supine lumbar MRIs were performed and immediately repeated with axial loading in 100 LBP patients. A total of 43 patients (23 male, mean age 45.7 years) had MCs. Each Modic was outlined on all sagittal T2-weighted images (>25% affected vertebrae). For reference, regions of interest were placed in both vertebrae without Modic and in Modic-free tissue in vertebrae with Modic. The Modic signal intensity, normalized to cerebrospinal fluid, and Modic volume were compared between MRIs with and without spinal loading. Of the 94 MCs, 36.2% (n = 34) were type I, 58.5% (n = 55) were type II, and 5.3% (n = 5) were type III. No differences in Modic volume (mean 0.046 cm(3); p = 0.25) between the MRIs with and without spinal loading were found. In addition, no significant changes in Modic signal were induced by loading (mean 1.5% difference; p = 0.308). Loading increased the signal in the reference regions of interest in vertebrae both with Modic (mean 5.5%; p = 0.002) and without (mean 3.5%; SD 0.09; p = 0.02). To conclude, MRIs performed with and without spinal loading showed no change in either volume or signal of MCs, suggesting that most MCs are not instantaneously influenced by biomechanical load.
format Online
Article
Text
id pubmed-9406333
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-94063332022-08-26 Loading of the Spine in Low Back Pain Patients Does Not Induce MRI Changes in Modic Lesions: A Prospective Clinical Study Hebelka, Hanna Brisby, Helena Erkmar, Alfred Lagerstrand, Kerstin Diagnostics (Basel) Article Modic changes (MCs) are gaining increased interest as potential generators of low back pain (LBP). The current aim was to investigate possible spinal loading effects on the MRI signal in MCs in patients with LBP. Supine lumbar MRIs were performed and immediately repeated with axial loading in 100 LBP patients. A total of 43 patients (23 male, mean age 45.7 years) had MCs. Each Modic was outlined on all sagittal T2-weighted images (>25% affected vertebrae). For reference, regions of interest were placed in both vertebrae without Modic and in Modic-free tissue in vertebrae with Modic. The Modic signal intensity, normalized to cerebrospinal fluid, and Modic volume were compared between MRIs with and without spinal loading. Of the 94 MCs, 36.2% (n = 34) were type I, 58.5% (n = 55) were type II, and 5.3% (n = 5) were type III. No differences in Modic volume (mean 0.046 cm(3); p = 0.25) between the MRIs with and without spinal loading were found. In addition, no significant changes in Modic signal were induced by loading (mean 1.5% difference; p = 0.308). Loading increased the signal in the reference regions of interest in vertebrae both with Modic (mean 5.5%; p = 0.002) and without (mean 3.5%; SD 0.09; p = 0.02). To conclude, MRIs performed with and without spinal loading showed no change in either volume or signal of MCs, suggesting that most MCs are not instantaneously influenced by biomechanical load. MDPI 2022-07-28 /pmc/articles/PMC9406333/ /pubmed/36010166 http://dx.doi.org/10.3390/diagnostics12081815 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Hebelka, Hanna
Brisby, Helena
Erkmar, Alfred
Lagerstrand, Kerstin
Loading of the Spine in Low Back Pain Patients Does Not Induce MRI Changes in Modic Lesions: A Prospective Clinical Study
title Loading of the Spine in Low Back Pain Patients Does Not Induce MRI Changes in Modic Lesions: A Prospective Clinical Study
title_full Loading of the Spine in Low Back Pain Patients Does Not Induce MRI Changes in Modic Lesions: A Prospective Clinical Study
title_fullStr Loading of the Spine in Low Back Pain Patients Does Not Induce MRI Changes in Modic Lesions: A Prospective Clinical Study
title_full_unstemmed Loading of the Spine in Low Back Pain Patients Does Not Induce MRI Changes in Modic Lesions: A Prospective Clinical Study
title_short Loading of the Spine in Low Back Pain Patients Does Not Induce MRI Changes in Modic Lesions: A Prospective Clinical Study
title_sort loading of the spine in low back pain patients does not induce mri changes in modic lesions: a prospective clinical study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9406333/
https://www.ncbi.nlm.nih.gov/pubmed/36010166
http://dx.doi.org/10.3390/diagnostics12081815
work_keys_str_mv AT hebelkahanna loadingofthespineinlowbackpainpatientsdoesnotinducemrichangesinmodiclesionsaprospectiveclinicalstudy
AT brisbyhelena loadingofthespineinlowbackpainpatientsdoesnotinducemrichangesinmodiclesionsaprospectiveclinicalstudy
AT erkmaralfred loadingofthespineinlowbackpainpatientsdoesnotinducemrichangesinmodiclesionsaprospectiveclinicalstudy
AT lagerstrandkerstin loadingofthespineinlowbackpainpatientsdoesnotinducemrichangesinmodiclesionsaprospectiveclinicalstudy