Modic Changes
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Clinically Relevant Anatomy may[edit | edit source]
Modic changes (MC) are bone marrow lesions seen within a vertebral body on magnetic resonance imaging (MRI), suggestive of being associated with low back pain (LBP). [1] Their presence in clients receiving physiotherapy for low back pain may be of significance when discussing prognosis and benefits of exercise therapy.
Mechanism of Injury / Pathological Process
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Research on the subject has been published since 1988 when MC were first identified by Dr. Michael Modic. Subsequent publications on the subject provided incremental gains in understanding of this new diagnostic entity. Though causes and mechanisms responsible for formation of MC are still poorly understood, progress is being made in linking his spinal phenotype with disc degeneration and LBP. This is significant as value MRI in management of LBP remains low due to lack of phenotypical features strongly correlating with clinical symptoms.
Clinical Presentation[edit | edit source]
The subgroup of LBP clients with MC seeking physiotherapy care may more often report:
- constant and nocturnal pain
- higher level of functional impairment
- lack of improvement at week 4 since onset or later.
- failed exercise therapy attempts
Proposed risk factors for developing MC include:
Physical examination findings may not be useful for differentiating between clients with and without MC and characteristic of degenerative disk disease.
Diagnostic Procedures[edit | edit source]
MRI
Outcome Measures[edit | edit source]
add links to outcome measures here (see Outcome Measures Database)
Management / Interventions
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Differential Diagnosis
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add text here relating to the differential diagnosis of this condition
Resources
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References[edit | edit source]
- ↑ 1.0 1.1 1.2 Mok FP, Samartzis D, Karppinen J, Fong DY, Luk KD, Cheung KM. Modic changes of the lumbar spine: prevalence, risk factors, and association with disc degeneration and low back pain in a large-scale population-based cohort. The Spine Journal. 2016 Jan 1;16(1):32-41.
- ↑ 2.0 2.1 Määttä JH, Wadge S, MacGregor A, Karppinen J, Williams FM. ISSLS prize winner: vertebral endplate (Modic) change is an independent risk factor for episodes of severe and disabling low back pain. Spine. 2015 Aug 1;40(15):1187-93.
- ↑ 3.0 3.1 Xia W, Liu C, Duan S, Xu S, Wang K, Zhu Z, Liu H. The influence of spinal-pelvic parameters on the prevalence of endplate Modic changes in degenerative thoracolumbar/lumbar kyphosis patients. PloS one. 2018 May 15;13(5):e0197470.
