title: The association between Modic changes and pain during 1-year follow-up in patients with lumbar radicular pain.
abstract: OBJECTIVE
  To examine whether Modic changes influence pain during a 1-year follow-up in patients with lumbar radicular pain.
  
  
  METHODS
  A total of 243 patients with lumbar radicular pain due to disc herniation were recruited from two hospitals in Norway and followed up at 6 weeks, 6 months, and 12 months. On baseline lumbar magnetic resonance images, two observers independently evaluated Modic changes (types I-III; craniocaudal size 0-3). Outcomes were sensory pain (McGill Pain Questionnaire), back and leg pain (visual analogue scale, VAS). Association between Modic type and outcomes was explored with a mixed model and then by two-way analysis of variance (ANOVA) at each time point with Modic and treatment groups (surgical, n = 126; nonsurgical, n = 117) as fixed factors, adjusted for disc degeneration, age, sex, smoking, and duration of radicular pain. Modic size was also analyzed using ANOVA.
  
  
  RESULTS
  Pain scores had decreased significantly at 1-year follow-up. Modic type was significantly related to McGill sensory scores (mixed model: p = 0.014-0.026; ANOVA: p = 0.007 at 6 weeks), but not to VAS back pain or VAS leg pain scores. At 6 weeks, the mean McGill sensory score was higher in Modic I than in Modic II-III patients (p = 0.003) and in patients without Modic changes (p = 0.018). Modic size L1-S1 was not associated with pain outcomes.
  
  
  CONCLUSIONS
  Patients with lumbar radicular pain have a substantial pain reduction during 1-year follow-up, but Modic type I changes may imply a slower initial decrease in sensory pain.
authors: Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Ullevål, Nydalen, Postbox 4956, 0424, Oslo, Norway, uxioel@ous-hf.no.
authors: Elina Iordanova
authors: EI
authors: Schistad
authors: Ansgar
authors: A
authors: Espeland
authors: Lars Jørgen
authors: LJ
authors: Rygh
authors: Cecilie
authors: C
authors: Røe
authors: Johannes
authors: J
authors: Gjerstad
mesh_terms: D000328:Adult; D017677:Age Distribution; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery*; D017116:Low Back Pain / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000706:statistics & numerical data; D008297:Male; D009664:Norway / Q000453:epidemiology; D010147:Pain Measurement / Q000706:statistics & numerical data; D015995:Prevalence; D011843:Radiculopathy / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery*; D017678:Sex Distribution; D013223:Statistics as Topic; D016896:Treatment Outcome