Article Text

PDF
FRI0549 Magnetic Resonance Imaging Structural Alterations Associated with Active Discopathy of the Lumbar Spine: Identification of Two Phenotypically Distinct Subsets of Vertebral Endplate Modic 1 Signal Changes
  1. C. Nguyen1,
  2. M. Jousse1,
  3. K. Sanchez1,
  4. A. Feydy2,
  5. M. Revel1,
  6. M.-M. Lefèvre-Colau1,
  7. S. Poiraudeau1,
  8. F. Rannou1
  1. 1Rehabilitation Department
  2. 2Radiology B Department, Univ. Paris Descartes, PRES Sorbonne Paris Cité, Hôpital Cochin, Assistance Publique - Hôpitaux de Paris, Paris, France

Abstract

Background Active discopathy detected on magnetic resonance imaging (MRI), and also known as Modic 1 signal changes, encompasses clinical, radiological and biological features, enabling to define a specific subset of patients with chronic low back pain (cLBP). Modic 1 changes are largely associated with degenerative disc disease (DDD) features, however we hypothesized that a specific subset of Modic 1 patients may display milder DDD.

Objectives To determine Modic 1 MRI-associated structural alterations, and to identify Modic 1 subsets based on MRI findings.

Methods MRI computerized database of a tertiary care hospital in France was searched between 01/01/2006 and 01/31/2008. MRI of the lumbar spine were systematically screened by two assessors. When Modic 1 changes were present at a single level on both adjacent endplates, MRI were considered eligible, and demographics and MRI-associated structural changes were assessed.

Results Out of 12,840 recorded MRI, 101 MRI were eligible. Patients' mean age was 56.6 (13.4) years and 41 (40.6%) were males. Modic 1 changes were more frequent at L4/L5 and L5/S1 levels (37[36.6%], respectively). The most frequent MRI-associated structural alterations were >50% intervertebral space narrowing (IVSN) (70[69.3%]), anterior (51[50.5%]) and posterior (56[55.4%]) disc herniations, and anterior (68[67.3%]) and lateral (59[58.4%]) osteophytes. ≤50% IVSN Modic 1 differed from >50% IVSN Modic 1. On bivariable analysis, patients were younger (51.5[14.1] vs 58.8[12.6] years, p=0.019), ≤50% IVSN Modic 1 were more often located at L5/S1 level (19[61.3%] vs 18[25.7%], p=0.001), and anterior and lateral osteophytes were less frequent (13[41.9%] vs 55[78.6%], p<0.001, and 11[35.5%] vs 48[68.6%], p=0.002, respectively). On multivariable analysis, variables independently associated with >50% IVSN Modic 1 were location at L4/L5 level, anterior disc herniation and lateral osteophyte.

Conclusions Modic 1 changes are frequently associated with MRI DDD features. However, we identified a distinct ≤50% IVSN Modic 1 subset that occurs in younger patients, and is associated with less advanced DDD features.

Disclosure of Interest None declared

Statistics from Altmetric.com

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.