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Are the determinants of vertebral endplate changes and severe disc degeneration in the lumbar spine the same? A magnetic resonance imaging study in middle-aged male workers.

Kuisma M, Karppinen J, Haapea M, Niinimäki J, Ojala R, Heliövaara M, Korpelainen R, Kaikkonen K, Taimela S, Natri A, Tervonen O - BMC Musculoskelet Disord (2008)

Bottom Line: Modic changes are bone marrow lesions visible in magnetic resonance imaging (MRI), and they are assumed to be associated with symptomatic intervertebral disc disease, especially changes located at L5-S1.Age was significantly associated with all degenerative changes.In the age-adjusted analyses, only weight-related determinants (BMI, waist circumference) were associated with type II changes.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland. mari.kuisma@fimnet.fi

ABSTRACT

Background: Modic changes are bone marrow lesions visible in magnetic resonance imaging (MRI), and they are assumed to be associated with symptomatic intervertebral disc disease, especially changes located at L5-S1. Only limited information exists about the determinants of Modic changes. The objective of this study was to evaluate the determinants of vertebral endplate (Modic) changes, and whether they are similar for Modic changes and severe disc degeneration focusing on L5-S1 level.

Methods: 228 middle-aged male workers (159 train engineers and 69 sedentary factory workers) from northern Finland underwent sagittal T1- and T2-weighted MRI. Modic changes and disc degeneration were analyzed from the scans. The participants responded to a questionnaire including items of occupational history and lifestyle factors. Logistic regression analysis was used to evaluate the associations between selected determinants (age, lifetime exercise, weight-related factors, fat percentage, smoking, alcohol use, lifetime whole-body vibration) and Modic type I and II changes, and severe disc degeneration (= grade V on Pfirrmann's classification).

Results: The prevalences of the Modic changes and severe disc degeneration were similar in the occupational groups. Age was significantly associated with all degenerative changes. In the age-adjusted analyses, only weight-related determinants (BMI, waist circumference) were associated with type II changes. Exposure to whole-body vibration, besides age, was the only significant determinant for severe disc degeneration. In the multivariate model, BMI was associated with type II changes at L5-S1 (OR 2.75 per one SD = 3 unit increment in BMI), and vibration exposure with severe disc degeneration at L5-S1 (OR 1.08 per one SD = 11-year increment in vibration exposure).

Conclusion: Besides age, weight-related factors seem important in the pathogenesis of Modic changes, whereas whole-body vibration was the only significant determinant of severe disc degeneration.

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Prevalence of Modic type I changes in discs from L1-2 to L5-S1 among train engineers and factory workers.
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Figure 2: Prevalence of Modic type I changes in discs from L1-2 to L5-S1 among train engineers and factory workers.

Mentions: When the occupational groups were analyzed separately, 87 (55%) of the train engineers and 41 (59%) of the factory workers were found to have Modic changes (P = 0.562). The corresponding figures for Modic I and II changes are shown in Table 2. The occurrence of Modic changes increased to the caudal direction in both occupational groups. 80% of Modic changes being located at the two lowest levels (Figures 2, 3).


Are the determinants of vertebral endplate changes and severe disc degeneration in the lumbar spine the same? A magnetic resonance imaging study in middle-aged male workers.

Kuisma M, Karppinen J, Haapea M, Niinimäki J, Ojala R, Heliövaara M, Korpelainen R, Kaikkonen K, Taimela S, Natri A, Tervonen O - BMC Musculoskelet Disord (2008)

Prevalence of Modic type I changes in discs from L1-2 to L5-S1 among train engineers and factory workers.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2373785&req=5

Figure 2: Prevalence of Modic type I changes in discs from L1-2 to L5-S1 among train engineers and factory workers.
Mentions: When the occupational groups were analyzed separately, 87 (55%) of the train engineers and 41 (59%) of the factory workers were found to have Modic changes (P = 0.562). The corresponding figures for Modic I and II changes are shown in Table 2. The occurrence of Modic changes increased to the caudal direction in both occupational groups. 80% of Modic changes being located at the two lowest levels (Figures 2, 3).

Bottom Line: Modic changes are bone marrow lesions visible in magnetic resonance imaging (MRI), and they are assumed to be associated with symptomatic intervertebral disc disease, especially changes located at L5-S1.Age was significantly associated with all degenerative changes.In the age-adjusted analyses, only weight-related determinants (BMI, waist circumference) were associated with type II changes.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland. mari.kuisma@fimnet.fi

ABSTRACT

Background: Modic changes are bone marrow lesions visible in magnetic resonance imaging (MRI), and they are assumed to be associated with symptomatic intervertebral disc disease, especially changes located at L5-S1. Only limited information exists about the determinants of Modic changes. The objective of this study was to evaluate the determinants of vertebral endplate (Modic) changes, and whether they are similar for Modic changes and severe disc degeneration focusing on L5-S1 level.

Methods: 228 middle-aged male workers (159 train engineers and 69 sedentary factory workers) from northern Finland underwent sagittal T1- and T2-weighted MRI. Modic changes and disc degeneration were analyzed from the scans. The participants responded to a questionnaire including items of occupational history and lifestyle factors. Logistic regression analysis was used to evaluate the associations between selected determinants (age, lifetime exercise, weight-related factors, fat percentage, smoking, alcohol use, lifetime whole-body vibration) and Modic type I and II changes, and severe disc degeneration (= grade V on Pfirrmann's classification).

Results: The prevalences of the Modic changes and severe disc degeneration were similar in the occupational groups. Age was significantly associated with all degenerative changes. In the age-adjusted analyses, only weight-related determinants (BMI, waist circumference) were associated with type II changes. Exposure to whole-body vibration, besides age, was the only significant determinant for severe disc degeneration. In the multivariate model, BMI was associated with type II changes at L5-S1 (OR 2.75 per one SD = 3 unit increment in BMI), and vibration exposure with severe disc degeneration at L5-S1 (OR 1.08 per one SD = 11-year increment in vibration exposure).

Conclusion: Besides age, weight-related factors seem important in the pathogenesis of Modic changes, whereas whole-body vibration was the only significant determinant of severe disc degeneration.

Show MeSH
Related in: MedlinePlus