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Table 1 Clinical characteristics of interest with rationale

From: Association of Modic change types and their short tau inversion recovery signals with clinical characteristics- a cross sectional study of chronic low back pain patients in the AIM-study

Description Rationale
Clinical History/Questionnaires
LBP intensity [33]
Mean of three 0–10 Numeric Rating Scales: current LBP, the worst LBP within the last 2 weeks, and usual/mean LBP within the last 2 weeks
Type 1 MCs are reported to be more strongly related to back pain than type 2 MCs [6, 11, 19,20,21,22,23, 34]
Leg pain intensity [35]
0–10 Numeric Rating Scales, last week.
Type 1 MCs may imply a slower initial decrease in sensory pain, but not leg pain intensity, compared to type 2 MCs in patients with radiculopathy [36]
Duration of back pain
Time since onset of present back pain
Type 1 MCs reflect an active process and are commonly considered to develop before type 2 MCs, which may reflect a chronic process [13]
Frequency of LBP
Number of days last 4 weeks with LBP and number of hours per day (average of 4 weeks) with back pain
Measures of frequency of LBP are found to be higher in patients with MCs than in patients without MCs [4]
Pain on movement
Effect of walking on pain and effect of physical exercise on pain (Q: “What effect does the following activities have on your present pain”?, alternative responses for both walking and physical exercise were “worse”, “same”, “improved”, “unsure” or “not applicable”).
Pain on movement at physical examination was one of the most strongly significant discriminators between patients with and without MCs [4]
LBP variation
Constant or intermittent LBP (Q: “Is the pain constant or intermittent throughout the day”?, alternative responses were “constant pain” or “intermittent pain”)
Constant pain is a clinical sign associated with regular spondylodiscitis [37], and low-grade disc infection is a hypothesized cause of MCs [38]
Previous operation for disc herniation
If the patient had been operated for disc herniation, MCs had to found at an operated level for the patient to be included in the study
Following lumbar discectomy, type 2 could be more common than type 1 MCs at the operated level [39]. There is a trend toward less improvement of LBP post-discectomy with type 1 compared to type 2 or no MCs [40].
Sleep disturbance
Assessed by Oswestry Disability Index- item 7, alternative responses were “my sleep is never disturbed by pain”, “my sleep is occasionally disturbed by pain”, “because of pain I have less than 6 h sleep”, “because of pain I have less than 4 h sleep”, “because of pain I have less than 2 h sleep” and “pain prevents me from sleeping at all”
Night pain was more common in type 1 MCs when compared to no MCs [41] or to type 2 MCs [11], and night pain is a clinical sign associated with regular spondylodiscitis [37] (low-grade disc infection is a hypothesized cause of MCs).
LBP prevents sitting
Assessed by Oswestry Disability Index- item 5, alternative responses were: “I can sit in any chair as long as I like”, “I can only sit in my favorite chair as long as I like”, “pain prevents me sitting more than one hour”, “pain prevents me from sitting more than 30 min”, “pain prevents me from sitting more than 10 min”, and “pain prevents me from sitting at all”)
Explorative outcome.
Physical Examination
Aggravation of pain by flexion of lumbar spine
Recorded “pain” or “no pain” during lumbar spine flexion
Pain on lumbar movement (flexion, extension or lateral flexion) may discriminate between patients with and without MCs [4]
Aggravation of pain by extension of lumbar spine
Recorded “pain” or “no pain” during lumbar spine extension
Pain on extension could be associated with MC type 1 [41, 42]
Springing test for pain
In our study, Springing test was positive if the patient reported pain with pressure applied to lumbar transverse processes. In these analyses, we defined the Springing test as positive if it was positive anywhere in the lumbar spine.
Potential discriminator between patients with and without MCs [4]. Spinal tenderness is associated with spondylodiscitis (low-grade disc infection is a hypothesized cause of MCs) [37].
  1. LBP Low back pain, MCs Modic Changes