title: Are Modic changes prognostic for recovery in a cohort of patients with non-specific low back pain?
abstract: BACKGROUND
  There is evidence for an association between Modic type 1 and pain in patients with low back pain (LBP), but little knowledge about its effect on clinical outcomes.
  
  
  OBJECTIVE
  (1) To assess the prevalence of Modic changes, (2) to determine if Modic changes influence the clinical course of LBP, and (3) to identify prognostic factors for recovery.
  
  
  METHODS
  Prospective clinical cohort study, with a 1-year follow-up. The treatment consisted of brief intervention and instruction in stretching.                                               PATIENT'S SAMPLE:                          Two hundred and sixty-nine patients with chronic low back pain.
  
  
  METHODS
  Socio-demographic variables, education, profession, self-reported measures, degenerative changes on MRI.
  
  
  METHODS
  Linear growth model and Cox regression analysis.
  
  
  RESULTS
  Five percent had a normal MRI, 14 and 50% had Modic 1 and Modic 2 changes. Modic changes were not significant covariates for the clinical course of pain, function or fear avoidance beliefs. Education was a strong prognostic factor for recovery.
  
  
  CONCLUSIONS
  Modic changes did not influence the clinical course of back pain and were not prognostic factors for recovery. Education was strongly associated with recovery.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Oslo University Hospital, 0407, Oslo, Norway. Anne.Keller@medisin.uio.no
authors.forename: Anne
authors.initials: A
authors.lastname: Keller
authors.forename: Eleanor
authors.initials: E
authors.lastname: Boyle
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Skog
authors.forename: J David
authors.initials: JD
authors.lastname: Cassidy
authors.forename: Erik
authors.initials: E
authors.lastname: Bautz-Holter
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005081:Exercise Therapy / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D055959:Intervertebral Disc Degeneration / Q000175:diagnosis* / Q000453:epidemiology* / Q000534:rehabilitation; D017116:Low Back Pain / Q000175:diagnosis* / Q000453:epidemiology* / Q000534:rehabilitation; D008159:Lumbar Vertebrae / Q000294:innervation / Q000473:pathology* / Q000503:physiopathology; D008279:Magnetic Resonance Imaging / Q000379:methods / Q000592:standards; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D020127:Recovery of Function / Q000502:physiology; D055815:Young Adult