DOS 2018
DOS Kongressen 2018 · 193 Is Modic changes related to long term disability Peter Muhareb Udby, Mikkel Østerheden Andersen, Tom Bendix, Stig Brorson, Søren Ohrt-Nissen, Leah Carreon , Michael Rud Lassen Orthopedic department, Spine section, Zealand University Hospital Koege; Spine Surgery and Research, Spine Center of Southern Denmark – part of Lillebaelt Hospital.; Videncenter for Rygsygdomme, Glostrup hospital - Rigshospitalet; Norton Leatherman Spine Center, Norton Leatherman Spine Center, Louisville Kentucky Background: Back pain is the leading global cause of disability. Some studies have shown that MC are strongly associated with low back pain (LBP) compared to disc degeneration alone. However, the long-term consequences in terms of Patient- Reported Outcomes (PROs) have not been reported. This study evalu- ated if MC is associated with long-term disability and pain. Purpose / Aim of Study: To evaluate is patients with Modic changes (MC) have worse long-term outcomes compared to patients without. Materials and Methods: In 2002, 207 patients with chronic low back pain were enrolled in an RCT comparing cognitive training with physical therapy. Inclusion criteria were age 18-60, almost daily LBP of ≥ 4 for more than 4 months in the past year. In 2017, these patients were then asked to complete the same PROs collected at baseline: back and leg pain (0-10), Roland-Morris Disability Questionnaire (RMDQ) and Inflammatory pain pattern (IPP). Patients were then stratified based on the presence or absence of MC on their initial low-Tesla MRI. Findings / Results: Of the 204 cases with MRIs in 2002, 82 (40%) had MC in a least one lumbar segment. In 2017, 167 cases (82%) were available for fol- low-up including 65 (39%) with MC. There were no differences in demograph- ics, smoking status, back-or leg-pain or IPP scores at baseline and at 13-year follow-up between patients with and without MC. RMDQ was similar in both groups at baseline but worse in patients without MC at follow-up. Conclusions: The current study showed that patients without MC who had pain and were referred to a back clinic have the same clinical presentation as patients with MC. However, patients with MC were found to have better long- term outcomes compared to patients without. 134.
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