title: The Association Between Modic Changes of Lumbar Endplates and Spontaneous Absorption of Herniated Intervertebral Discs.
abstract: Herniated disc (HD) is one of the most common causes of lower back pain. Treatment for HD includes conservative therapy and surgical intervention. Following conservative treatment, spontaneous absorption of HD occurs in some patients. To assess whether modic changes are associated with spontaneous absorption of HD, 85 patients with or without modic changes were followed up after 6 months of conservative treatment. As result, we found modic changes of lumbar endplates are associated with poor absorption of HD after conservative treatment. In addition, patients with modic changes exhibit significantly increased cartilage content and decreased neovascularization and macrophage infiltration in HD tissues, all of which are known to impair spontaneous absorption of herniated tissues. At molecular level, modic changes are associated with decreased expression of matrix metalloproteinase-3 gene, which is a key matrix-degrading enzyme for tissue absorption. Our study established a strong association between modic changes of lumbar endplates and spontaneous absorption of lumbar HD, which provided a potential novel method for prediction of spontaneous absorption.
authors.affiliation: Department of Orthopedics, Taizhou Central Hospital, 999 Donghai Avenue, Taizhou, 318000, China. dinglingzhi2013@163.com.
authors.forename: Lingzhi
authors.initials: L
authors.lastname: Ding
authors.affiliation: Department of Orthopedics, Taizhou Central Hospital, 999 Donghai Avenue, Taizhou, 318000, China.
authors.forename: Xiao
authors.initials: X
authors.lastname: Teng
authors.affiliation: Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, 310016, China.
authors.forename: Shunwu
authors.initials: S
authors.lastname: Fan
authors.affiliation: Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, 310016, China.
authors.forename: Fengdong
authors.initials: F
authors.lastname: Zhao
mesh_terms: D065966:Absorption, Physicochemical; D000203:Activities of Daily Living; D000328:Adult; D005260:Female; D015971:Gene Expression Regulation, Enzymologic; D006801:Humans; D051457:Hyaline Cartilage / Q000378:metabolism; D007403:Intervertebral Disc / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery; D007405:Intervertebral Disc Displacement / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery; D008264:Macrophages / Q000276:immunology; D008279:Magnetic Resonance Imaging; D008297:Male; D019278:Matrix Metalloproteinase 3 / Q000378:metabolism; D008875:Middle Aged; D018919:Neovascularization, Physiologic; D055815:Young Adult
chemical_list: D019278:Matrix Metalloproteinase 3
keywords: Herniated disc; MMP-3; Modic changes; Neovascularization; Spontaneous absorption