nach oben

Erschienen in:

01.01.2010 | Original Article

Predictors of new vertebral endplate signal (Modic) changes in the general population

verfasst von: Tue Secher Jensen, Per Kjaer, Lars Korsholm, Tom Bendix, Joan S. Sorensen, Claus Manniche, Charlotte Leboeuf-Yde

Erschienen in: European Spine Journal | Ausgabe 1/2010

Einloggen, um Zugang zu erhalten

Abstract

Vertebral endplate signal changes (VESC), also known as Modic changes, have been reported to be associated with low back pain (LBP). However, little is known about predisposing factors for the development of new VESC. The aim of this study was to investigate the predictive value of lifestyle factors and disc-related magnetic resonance imaging (MRI) findings in relation to the development of new VESC. This prospective observational study included 344 people from the Danish general population who had an MRI and completed LBP questionnaires at the age of 40 and again at 44 years. Potential predictors of new VESC were female gender, disc-related MRI findings (disc degeneration, disc bulges, disc herniation, and other endplate changes) and lifestyle factors [high physical work or leisure activity, high body mass index (BMI), and heavy smoking]. Bivariate and multivariate logistic regressions were used to identify predictors of new VESC. New VESC at the age of 44 appeared in 67 of the 344. The majority (84%) of these new signal changes were type 1 VESC and almost half (45%) were only in the endplate and did not extend into the vertebral body. In the multivariate analysis, lumbar disc levels with disc degeneration, bulges or herniations at 40 were the only predictors of new VESC at age 44. Therefore, the development of new VESC at the age of 44 appears to be based on the status and dynamics of the disc, rather than being the result of gender or lifestyle factors such as smoking and physical load.

Adams MA, Freeman BJ, Morrison HP, Nelson IW, Dolan P (2000) Mechanical initiation of intervertebral disc degeneration. Spine 25:1625–1636CrossRefPubMed

Albert HB, Manniche C (2007) Modic changes following lumbar disc herniation. Eur Spine J 16:977–982CrossRefPubMed

Barth M, Diepers M, Weiss C, Thome C (2008) Two-year outcome after lumbar microdiscectomy versus microscopic sequestrectomy: part 2: radiographic evaluation and correlation with clinical outcome. Spine 33:273–279CrossRefPubMed

Bazrgari B, Shirazi-Adl A, Arjmand N (2007) Analysis of squat and stoop dynamic liftings: muscle forces and internal spinal loads. Eur Spine J 16:687–699CrossRefPubMed

Braithwaite I, White J, Saifuddin A, Renton P, Taylor BA (1998) Vertebral end-plate (Modic) changes on lumbar spine MRI: correlation with pain reproduction at lumbar discography. Eur Spine J 7:363–368CrossRefPubMed

Cvitanic OA, Schimandle J, Casper GD, Tirman PF (2000) Subchondral marrow changes after laser discectomy in the lumbar spine: MR imaging findings and clinical correlation. Am J Roentgenol 174:1363–1369

Elfering A, Semmer N, Birkhofer D, Zanetti M, Hodler J, Boos N (2002) Risk factors for lumbar disc degeneration: a 5-year prospective MRI study in asymptomatic individuals. Spine 27:125–134CrossRefPubMed

Eyre D, Nemya P, Buckwalter J, Caterson N, Heinegard D, Oegema T (1989) Intervertebral disk: basic science perspectives. In: Frymoyer JW, Gordon SL et al (eds) New perspectives on low back pain. American Academy of Orthopaedic Surgeons, Park Ridge, pp 147–207

Fardon DF, Milette PC (2001) Nomenclature and classification of lumbar disc pathology. Recommendations of the Combined task Forces of the North American Spine Society, American Society of Spine Radiology, and American Society of Neuroradiology. Spine 26:E93–E113CrossRefPubMed

10.

Heliovaara M (1989) Risk factors for low back pain and sciatica. Ann Med 21:257–264CrossRefPubMed

11.

Hildebrandt VH, Bongers PM, Dul J, van Dijk FJ, Kemper HC (2000) The relationship between leisure time, physical activities and musculoskeletal symptoms and disability in worker populations. Int Arch Occup Environ Health 73:507–518CrossRefPubMed

12.

Hopper JL, Seeman E (1994) The bone density of female twins discordant for tobacco use. N Engl J Med 330:387–392CrossRefPubMed

13.

Ito M, Incorvaia KM, Yu SF, Fredrickson BE, Yuan HA, Rosenbaum AE (1998) Predictive signs of discogenic lumbar pain on magnetic resonance imaging with discography correlation. Spine 23:1252–1258CrossRefPubMed

14.

Iwahashi M, Matsuzaki H, Tokuhashi Y, Wakabayashi K, Uematsu Y (2002) Mechanism of intervertebral disc degeneration caused by nicotine in rabbits to explicate intervertebral disc disorders caused by smoking. Spine 27:1396–1401CrossRefPubMed

15.

Jensen TS, Bendix T, Sorensen JS, Manniche C, Korsholm L, Kjaer P (2009) Characteristics and natural course of vertebral endplate signal (Modic) changes in the Danish general population. BMC Musculoskelet Disord 10:81CrossRefPubMed

16.

Jensen TS, Karppinen J, Sorensen JS, Niinimaki J, Leboeuf-Yde C (2008) Vertebral endplate signal changes (Modic change): a systematic literature review of prevalence and association with non-specific low back pain. Eur Spine J 17:1407–1422CrossRefPubMed

17.

Jensen TS, Sorensen JS, Kjaer P (2007) Intra- and interobserver reproducibility of vertebral endplate signal (modic) changes in the lumbar spine: the Nordic Modic Consensus Group classification. Acta Radiol 48:748–754CrossRefPubMed

18.

Kjaer P, Leboeuf-Yde C, Korsholm L, Sorensen JS, Bendix T (2005) Magnetic resonance imaging and low back pain in adults: a diagnostic imaging study of 40-year-old men and women. Spine 30:1173–1180CrossRefPubMed

19.

Kovacs FM, Royuela A, Jensen TS, Estremera A, Amengual G, Muriel A et al (2009) Agreement in the interpretation of lumbar magnetic resonance images. Acta Radiol 50:497–506CrossRefPubMed

20.

Kuisma M, Karppinen J, Niinimaki J, Kurunlahti M, Haapea M, Vanharanta H et al (2006) A three-year follow-up of lumbar spine endplate (Modic) changes. Spine 31:1714–1718CrossRefPubMed

21.

Kuisma M, Karppinen J, Niinimaki J, Ojala R, Haapea M, Heliovaara M et al (2007) Modic changes in endplates of lumbar vertebral bodies: prevalence and association with low back and sciatic pain among middle-aged male workers. Spine 32:1116–1122CrossRefPubMed

22.

Kuorinka I, Jonsson B, Kilbom A, Biering-Sorensen F, Andersson G, Jørgensen K (1987) Standardised Nordic questionnaires for the analysis of musculoskeletal symptoms. Appl Ergon 18:233–237CrossRefPubMed

23.

Leboeuf-Yde C, Kjaer P, Bendix T, Manniche C (2008) Self-reported hard physical work combined with heavy smoking or overweight may result in so-called Modic changes. BMC Musculoskelet Disord 9:5CrossRefPubMed

24.

Liuke M, Solovieva S, Lamminen A, Luoma K, Leino-Arjas P, Luukkonen R et al (2005) Disc degeneration of the lumbar spine in relation to overweight. Int J Obes (Lond) 29:903–908CrossRef

25.

Luoma K, Riihimaki H, Raininko R, Luukkonen R, Lamminen A, Viikari-Juntura E (1998) Lumbar disc degeneration in relation to occupation. Scand J Work Environ Health 24:358–366PubMed

26.

Malinin T, Brown MD (2007) Changes in vertebral bodies adjacent to acutely narrowed intervertebral discs: observations in baboons. Spine 32:E603–E607CrossRefPubMed

27.

Modic MT, Masaryk TJ, Ross JS, Carter JR (1988) Imaging of degenerative disk disease. Radiology 168:177–186PubMed

28.

Modic MT, Steinberg PM, Ross JS, Masaryk TJ, Carter JR (1988) Degenerative disk disease: assessment of changes in vertebral body marrow with MR imaging. Radiology 166:193–199PubMed

29.

Moore RJ, Vernon-Roberts B, Osti OL, Fraser RD (1996) Remodeling of vertebral bone after outer anular injury in sheep. Spine 21:936–940CrossRefPubMed

30.

Papaioannou A, Kennedy CC, Cranney A, Hawker G, Brown JP, Kaiser SM et al (2009) Risk factors for low BMD in healthy men age 50 years or older: a systematic review. Osteoporos Int 20:507–518CrossRefPubMed

31.

Raininko R, Manninen H, Battie MC, Gibbons LE, Gill K, Fisher LD (1995) Observer variability in the assessment of disc degeneration on magnetic resonance images of the lumbar and thoracic spine. Spine 20:1029–1035CrossRefPubMed

32.

Rasmussen C (1998) [Lumbar disk prolapse. Alcohol, tobacco and prognosis]. Ugeskr Laeg 160:5189–5192PubMed

33.

Roberts N, Gratin C, Whitehouse GH (1997) MRI analysis of lumbar intervertebral disc height in young and older populations. J Magn Reson Imaging 7:880–886CrossRefPubMed

34.

Salo J, Mackiewicz Z, Indahl A, Konttinen YT, Holm AK, Sukura A et al (2008) Plasmin-matrix metalloproteinase cascades in spinal response to an experimental disc lesion in pig. Spine 33:839–844CrossRefPubMed

35.

Schenk P, Laubli T, Hodler J, Klipstein A (2006) Magnetic resonance imaging of the lumbar spine: findings in female subjects from administrative and nursing professions. Spine 31:2701–2706CrossRefPubMed

36.

Schmid G, Witteler A, Willburger R, Kuhnen C, Jergas M, Koester O (2004) Lumbar disk herniation: correlation of histologic findings with marrow signal intensity changes in vertebral endplates at MR imaging. Radiology 231:352–358CrossRefPubMed

37.

Sigurdsson G, Aspelund T, Chang M, Jonsdottir B, Sigurdsson S, Eiriksdottir G et al (2006) Increasing sex difference in bone strength in old age: the age, gene/environment susceptibility-Reykjavik study (AGES-REYKJAVIK). Bone 39:644–651CrossRefPubMed

38.

Slemenda CW, Christian JC, Reed T, Reister TK, Williams CJ, Johnston CC Jr (1992) Long-term bone loss in men: effects of genetic and environmental factors. Ann Intern Med 117:286–291PubMed

39.

Solgaard SJ, Kjaer P, Jensen ST, Andersen P (2006) Low-field magnetic resonance imaging of the lumbar spine: reliability of qualitative evaluation of disc and muscle parameters. Acta Radiol 47:947–953CrossRef

40.

Ulrich JA, Liebenberg EC, Thuillier DU, Lotz JC (2007) ISSLS prize winner: repeated disc injury causes persistent inflammation. Spine 32:2812–2819CrossRefPubMed

41.

Videman T, Battie MC, Gill K, Manninen H, Gibbons LE, Fisher LD (1995) Magnetic resonance imaging findings and their relationships in the thoracic and lumbar spine. Insights into the etiopathogenesis of spinal degeneration. Spine 20:928–935PubMedCrossRef

42.

Weishaupt D, Zanetti M, Hodler J, Boos N (1998) MR imaging of the lumbar spine: prevalence of intervertebral disk extrusion and sequestration, nerve root compression, end plate abnormalities, and osteoarthritis of the facet joints in asymptomatic volunteers. Radiology 209:661–666PubMed

43.

Weishaupt D, Zanetti M, Hodler J, Min K, Fuchs B, Pfirrmann CW et al (2001) Painful lumbar disk derangement: relevance of endplate abnormalities at MR imaging. Radiology 218:420–427PubMed

Titel: Predictors of new vertebral endplate signal (Modic) changes in the general population
verfasst von: Tue Secher Jensen
Per Kjaer
Lars Korsholm
Tom Bendix
Joan S. Sorensen
Claus Manniche
Charlotte Leboeuf-Yde
Publikationsdatum: 01.01.2010
Verlag: Springer-Verlag
Erschienen in: European Spine Journal / Ausgabe 1/2010
Print ISSN: 0940-6719
Elektronische ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-009-1184-5

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen.
» Jetzt entdecken

Neu im Fachgebiet Orthopädie und Unfallchirurgie

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Arthroskopie kann Knieprothese nicht hinauszögern

25.04.2024 Gonarthrose Nachrichten

Ein arthroskopischer Eingriff bei Kniearthrose macht im Hinblick darauf, ob und wann ein Gelenkersatz fällig wird, offenbar keinen Unterschied.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Ärztliche Empathie hilft gegen Rückenschmerzen

23.04.2024 Leitsymptom Rückenschmerzen Nachrichten

Personen mit chronischen Rückenschmerzen, die von einfühlsamen Ärzten und Ärztinnen betreut werden, berichten über weniger Beschwerden und eine bessere Lebensqualität.

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Abstract

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 1/2010

Transpedicular closed wedge osteotomy in ankylosing spondylitis: results of surgical treatment and prospective outcome analysis

Subaxial cervical pedicle screw insertion with newly defined entry point and trajectory: accuracy evaluation in cadavers

The Michel Benoist and Robert Mulholland yearly European Spine Journal Review: a survey of the “surgical and research” articles in the European Spine Journal, 2009

Safety of thoracic pedicle screw application using the funnel technique in Asians: a cadaveric evaluation

Expert’s comment concerning Grand Rounds case entitled “Langerhans cell histiocytosis of the atlas in an adult” (by Wo Quan Zhong, Liang Jiang, Qing Jun Ma, Zhong Jun Liu, Xiao Guang Liu, Feng Wei, Hui Shu Yuan, Geng Ting Dang)