Evaluation of Effect of Modic Changes on Treatment Outcomes of Nonspecific Low Back Pain Patients Presenting to 501 Hospitals Receiving Conservative Treatments

Abstract

Background: Modic changes (MC) are among the pain generators in the lumbar spine and could affect back pain treatments. Objectives: The current study aimed to investigate the effect of MC on the treatment outcomes of low back pain (LBP) patients who underwent conservative treatments. Methods: This prospective cohort study was performed on 166 nonspecific LBP patients presenting to 501 Hospital receiving conservative treatments. The patients were categorized based on their MC status, which was determined using a magnetic resonance imaging scan at baseline. Japanese Orthopedic Association (JOA) score was considered a measure of back pain and disability using a valid and reliable questionnaire for each participant. The data were collected on the age, gender, and duration of pain for each participant. The follow-up JOA score was also calculated for each patient after 6-month conservative treatments. The patient was considered improved if the JOA change score was higher than 0. Results: The average baseline JOA score in MC patients was 14.3 (2.2); however, it was 14.4 (2.0) in patients without MC (P = 0.750). After 6-month conservative treatments, the average JOA score reached 16.7 (3.4) and 17.1 (2.9) in patients with and without MC, respectively. No statistically significant difference was observed in this regard (P = 0.540). The proportion of improved cases was 70.7%, 82.8%, 63.4%, and 50.0% in no MC, MC type I, MC type II, and MC type III, respectively, with no statistically significant difference among the groups (P = 0.561). Conclusions: A 6-month conservative treatment was a safe and effective approach to improving the clinical condition of patients with LBP. However, there was no association between the presence of MC or any specific type of MC and treatment outcomes.