SynthesisPloS one2018
Modic changes-Their associations with low back pain and activity limitation: A systematic literature review and meta-analysis.
Synthesis in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 85 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
85 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Prevalence of thoracic degenerative MRI findings and association with pain and disability: a systematic review.Skeletal radiology · 2025Pooled it
- Evaluating the Impact of Modic Changes on Operative Treatment in the Cervical and Lumbar Spine: A Systematic Review and Meta-Analysis.International journal of environmental research and public health · 2022Pooled it
- Efficacy of a Tumor Necrosis Factor Inhibitor in Chronic Low-Back Pain With Modic Type 1 Changes: A Randomized Controlled Trial.Arthritis & rheumatology (Hoboken, N.J.) · 2025Trial
- Providing Epidemiological Data in Lumbar Spine Imaging Reports Did Not Affect Subsequent Utilization of Spine Procedures: Secondary Outcomes from a Stepped-Wedge Randomized Controlled Trial.Pain medicine (Malden, Mass.) · 2021Trial
- Oedema on STIR modified the effect of amoxicillin as treatment for chronic low back pain with Modic changes-subgroup analysis of a randomized trial.European radiology · 2021Trial
- Trial
- 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.BMC musculoskeletal disorders · 2020Trial
- Efficacy of antibiotic treatment in patients with chronic low back pain and Modic changes (the AIM study): double blind, randomised, placebo controlled, multicentre trial.BMJ (Clinical research ed.) · 2019Trial
- Modic changes, chronic low back pain, and lifestyle and mental health factors: a cross-sectional analysis of a cohort study.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026Article
- Pamidronate is ineffective for inflammatory-like low back pain associated with Modic type 1 changes: A double-blind, randomised controlled trial.Osteoarthritis and cartilage open · 2026Article
- Blood immune profiles in chronic low back pain patients with type 1 Modic changes are associated with intradiscal propionic acid levels.Research square · 2026Article
- IntradiscalJOR spine · 2026Article
- Modic changes and their role in vertebrogenic back pain: a literature review.Skeletal radiology · 2026Review
- From Modic changes to the disc-endplate-bone marrow complex: imaging stratification, immune remodeling, and translational implications in intervertebral disc degeneration.Frontiers in immunology · 2026Review
- Diagnostic evidence in suspected discogenic low back pain: a pain-source attribution perspective.Frontiers in medicine · 2026Review
- Gaps in Population Life Course Phenotype Trajectories Underlying Major Noncommunicable Diseases: A Scoping Review.International journal of population data science · 2026Article
- Article
- Prevalence and distribution of Modic Changes and association with low back pain : a descriptive analysis.Bone & joint open · 2025Article
- A scoping review of adult NCD-relevant phenotypes measured in today's large child cohort studies.Pediatric research · 2025Article
- Synergistic Effects of Basivertebral Nerve Ablation Plus Schroth Therapy for Adult Scoliosis: A Multicenter Propensity-Matched Cohort Study.Pain and therapy · 2025Article
25 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPrevious systematic reviews have reported positive associations between Modic changes (MCs) and low back pain (LBP), but due to their narrow scope and new primary studies, there is a need for a comprehensive systematic review. Our objectives were to investigate if MCs are associated with non-specific LBP and/or activity limitation and if such associations are modified by other factors.
methodsA protocol for this review was registered at PROSPERO prior to commencing the work (PROSPERO record: CRD42015017350). The MEDLINE, CINAHL and EMBASE databases were searched for relevant studies from first record to June 15th 2016. Prospective or retrospective cross-sectional cohort studies and case-control studies including people of all ages from general, working and clinical study populations were eligible for inclusion. Risk of bias assessment and data extraction for associations and potential modifiers were completed independently by pairs of reviewers. Meta-analysis was performed for homogeneous studies and presented as odds ratios (OR) with 95% CI.
resultsIn all, 5210 citations were identified and 31 studies were included. One study had low risk of bias. Fifteen studies (48%) reported statistically significant positive associations between MCs and LBP and one study found a statistically significant negative association. Meta-analysis performed for studies using concordant pain with provocative discography as the clinical outcome resulted in an OR of 4.01 (1.52-10.61). One of seven studies reported a statistically significant positive association between MCs and activity limitation. Lumbar disc level and disc degeneration were found to modify the association between MCs and LBP.
conclusionsThe results from this comprehensive systematic review indicate that the associations between MCs and LBP-related outcomes are inconsistent. The high risk of bias and the heterogeneity in terms of study samples, clinical outcomes and prevalence estimates of MCs and LBP may explain these findings. It is likely that new studies with low risk of bias will affect the direction and strength of these associations.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.