Spine Unit, Department of Orthopedic Surgery, Zealand University Hospital, Køge, Denmark.
Spine Unit, Department of Orthopaedic Surgery, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
Spine (Phila Pa 1976). 2019 Sep 1;44(17):1186-1192. doi: 10.1097/BRS.0000000000003051.
A comparative cohort study with 13-year follow-up.
To assess whether Modic changes (MCs) are associated with long-term physical disability, back pain, and sick leave.
Previous studies have shown a conflicting association of low back pain (LBP) with MCs and disc degeneration. The long-term prognosis of patients with MCs is unclear.
In 2004 to 2005, patients aged 18 to 60 with daily LBP were enrolled in an randomized controlled trial study and lumbar magnetic resonance imaging (MRI) was performed. Patients completed numeric rating scales (0-10) for LBP and leg pain, Roland-Morris Disability Questionnaire (RMDQ), LBP Rating Scale for activity limitations (RS, 0-30), inflammatory pain pattern and sick leave days due to LBP at baseline and 13 years after the MRI. Patients were stratified based on the presence (+MC) or absence (-MC) of MCs on the MRI.
Of 204 cases with baseline MRI, 170 (83%) were available for follow-up; 67 (39%) with MCs and 103 (61%) without MCs. Demographics, smoking status, BMI, use of antibiotics, LBP, leg pain, and inflammatory pain pattern scores at baseline and at 13-year follow-up were similar between the two groups. Also, baseline RMDQ was similar between the +MC and -MC groups. At 13 years, the RMDQ score was statistically significant better in the +MC group (7.4) compared with the -MC group (9.6, P = 0.024). Sick leave days due to LBP were similar at baseline but less in the +MC group (9.0) compared with the -MC group (22.9 d, P = 0.003) at 13 years.
MCs were not found to be negatively associated with long-term pain, disability, or sick leave. Rather, the study found that LBP patients with MCs had significantly less disability and sick-leave at long-term follow-up. We encourage further studies to elucidate these findings.
一项具有 13 年随访的对比队列研究。
评估 Modic 改变（MCs）是否与长期身体残疾、背痛和病假有关。
先前的研究表明，低背痛（LBP）与 MCs 和椎间盘退变之间的关联存在冲突。MCs 患者的长期预后尚不清楚。
在 2004 年至 2005 年期间，招募了年龄在 18 至 60 岁之间、每日有背痛的患者参与一项随机对照试验研究，并进行了腰椎磁共振成像（MRI）检查。患者在基线和 MRI 后 13 年完成了数值评定量表（0-10），用于背痛和腿痛、Roland-Morris 残疾问卷（RMDQ）、背痛活动受限评分量表（RS，0-30）、炎症性疼痛模式和因背痛请病假的天数。根据 MRI 上 MCs 的存在（+MC）或不存在（-MC）对患者进行分层。
在 204 例基线 MRI 患者中，有 170 例（83%）可进行随访；其中 67 例（39%）有 MCs，103 例（61%）没有 MCs。两组患者的人口统计学数据、吸烟状况、BMI、使用抗生素、基线时的背痛、腿痛和炎症性疼痛模式评分以及 13 年随访时的评分相似。基线 RMDQ 评分在+MC 组和-MC 组之间也相似。13 年后，+MC 组的 RMDQ 评分（7.4）明显优于-MC 组（9.6，P=0.024）。基线时的病假天数相似，但 13 年后+MC 组（9.0）的病假天数少于-MC 组（22.9 天，P=0.003）。
MCs 与长期疼痛、残疾或病假之间不存在负相关。相反，该研究发现，MCs 的 LBP 患者在长期随访中残疾和病假明显减少。我们鼓励进一步研究阐明这些发现。
2 级。
