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ID 115731
Author
Nagamachi, Akihiro Tokushima University
Keywords
Modic change
lumbar spine
lamina
intervertebral disc
facet joint
Content Type
Journal Article
Description
Introduction: Modic type 1 changes around the vertebral endplate of the lumbar spine are well known to indicate inflammation; however, the clinical significance of similar SCs of the posterior elements has not been elucidated.
Methods: Six hundred ninety-eight MRIs of patients with complaints of low back/leg pain were retrospectively examined. Target SCs in this study were hypointensity on T1-WI and hyperintensity on T2-WI or short tau inversion recovery sequences showing the same signal patterns seen in Modic type 1 change of the lumbar posterior elements. We analyzed the (1) Prevalence, symptom, and age distribution of SCs, (2) Localization of SCs and their association with Modic type 1 changes, (3) Spinal level distribution of SCs, (4) Association between SCs and disc degeneration of the affected spinal level, and (5) Association between SCs and radiological changes (spondylolisthesis, scoliosis).
Results: (1) Among 698 adult patients, 36 (16 men, 20 women) exhibited SCs (5.2%). No SCs were identified in patients age <40 years. (2) Of the 36 SCs, 9 (25%) were localized at a single spinal level, while 27 (75%) were found at neighboring spinal levels across the facet joint. Thirteen SCs (36.1%) had continuity with Modic type 1 changes around the vertebral endplate, while 23 (63.9%) were localized to the posterior elements. (3) SCs were frequently identified in the lower lumbar spine below the L4 level. (4) More than 80% of the SCs involved disc degeneration. (5) Spondylolisthesis was associated with 93% of SCs in double-level, and scoliosis was associated with SCs in unilateral side.
Conclusion: The prevalence of SCs in symptomatic adults was 5.2%. On the basis of observed disc degeneration, 75% of SCs were considered to indicate inflammation or bone marrow edema around the facet joint.
Journal Title
Spine Surgery and Related Research
ISSN
2432261X
Publisher
The Japanese Society for Spine Surgery and Related Research
Volume
1
Issue
3
Start Page
140
End Page
145
Published Date
2017-07-20
Rights
Spine Surgery and Related Research is an Open Access article distributed under the Creative Commons Attribution‐NonCommercial‐NoDerivatives 4.0 International License. To view the details of this license, please visit (https://creativecommons.org/licenses/by-nc-nd/4.0/).
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language
eng
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departments
Medical Sciences
University Hospital