title: Modic changes and associated features in Southern European chronic low back pain patients.
abstract: BACKGROUND
  Conflicting reports exist regarding the prevalence of Modic changes among low back pain (LBP) patients and factors associated with their existence.
  
  
  OBJECTIVE
  To assess the prevalence of Modic changes and other findings on lumbar magnetic resonance imaging (MRI) among Spanish adult chronic LBP patients and the patient characteristics and radiological findings associated with Modic changes.
  
  
  METHODS
  A cross-sectional imaging study among chronic LBP patients.
  
  
  METHODS
  Four hundred eighty-seven patients (263 women and 224 men) undergoing lumbar spine MRI examination for chronic LBP.
  
  
  METHODS
  Gender, age, body mass index (BMI), lifetime smoking exposure, degree of physical activity, and image features (disc degeneration, type and extension of Modic changes, disc contour, annular tears, spinal stenosis, and spondylolisthesis).
  
  
  METHODS
  Ten radiologists from six hospitals across six cities in Spain consecutively recruited adult patients in whom lumbar MRI had been prescribed for LBP lasting ≥3 months. Patients' characteristics and imaging findings were assessed through previously validated instruments. A multivariate logistic regression model was developed to assess the features associated with Modic changes.
  
  
  RESULTS
  Modic changes were found in 81% of the patients. The most common was Type II (51.3%), affecting only the end plate. Variables associated with Type I changes were disc contour abnormalities, spondylolisthesis, and disc degeneration. The same variables were associated with a higher risk of Type II or any type of Modic changes, as well as being male, and having a higher BMI.
  
  
  CONCLUSIONS
  Modic changes are found in 81% (95% confidence interval, 77-85) of adult Spanish patients in whom an MRI is prescribed for chronic LBP. Modic changes are more likely to be found in males with a high BMI, who also show disc contour abnormalities, spondylolisthesis, or disc degeneration.
authors.affiliation: Servicio de Radiología, Fundación Instituto Valenciano de Oncología, C/ Beltrán Báguena 19, Valencia, Spain. aranae@uv.es
authors.forename: Estanislao
authors.initials: E
authors.lastname: Arana
authors.forename: Francisco M
authors.initials: FM
authors.lastname: Kovacs
authors.forename: Ana
authors.initials: A
authors.lastname: Royuela
authors.forename: Ana
authors.initials: A
authors.lastname: Estremera
authors.forename: Beatriz
authors.initials: B
authors.lastname: Asenjo
authors.forename: Helena
authors.initials: H
authors.lastname: Sarasíbar
authors.forename: Guillermo
authors.initials: G
authors.lastname: Amengual
authors.forename: Isabel
authors.initials: I
authors.lastname: Galarraga
authors.forename: Ana
authors.initials: A
authors.lastname: Alonso
authors.forename: Carlos
authors.initials: C
authors.lastname: Casillas
authors.forename: Alfonso
authors.initials: A
authors.lastname: Muriel
authors.forename: Julia
authors.initials: J
authors.lastname: Montoya
authors.forename: Cristina
authors.initials: C
authors.lastname: Ordóñez
authors.forename: Carmen
authors.initials: C
authors.lastname: Martínez
authors.forename: Javier
authors.initials: J
authors.lastname: Zamora
authors.forename: Carlos
authors.initials: C
authors.lastname: Campillo
authors.forename: Víctor
authors.initials: V
authors.lastname: Abraira
mesh_terms: D000328:Adult; D002908:Chronic Disease; D015331:Cohort Studies; D015897:Comorbidity; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D008279:Magnetic Resonance Imaging; D008297:Male; D010147:Pain Measurement; D015995:Prevalence; D012585:Sciatica / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D013030:Spain / Q000453:epidemiology; D013122:Spinal Diseases / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology