ReviewJournal of orthopaedic surgery and research2023
Modic changes as seen on MRI are associated with nonspecific chronic lower back pain and disability.
Review in Journal of orthopaedic surgery and research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
What it found
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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
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Who cites it
16 citing papers in PubMed, 23 citations in OpenAlex.
- Lumbar Magnetic Resonance Imaging Profiles and Their Association with Low Back Pain in Dentists: A Cluster Analysis Study.Diagnostics (Basel, Switzerland) · 2026Article
- ISSLS Prize in Bioengineering Science 2026: Hidden in Plain Sight: Machine Learning-Assisted MRI Reveals Novel Vertebral Body Biomarkers of Chronic Low Back Pain in Humans.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
- Intradiscal linezolid (PP353) treatment for chronic low back pain associated with Modic change type 1: an international, first-in-human, randomised, sham procedure-controlled, double-blind, phase 1b clinical trial.EClinicalMedicine · 2026Article
- Modic changes and their role in vertebrogenic back pain: a literature review.Skeletal radiology · 2026Review
- Diagnostic evidence in suspected discogenic low back pain: a pain-source attribution perspective.Frontiers in medicine · 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
- Development of a predictive model for adverse outcomes after unilateral biportal endoscopic spine surgery in the treatment of lumbar disc herniation using six interpretable machine learning models.Frontiers in surgery · 2026Article
- Bibliometric and Visualized Analysis of Research Relating to Spinal Modic Changes Reported Over the Period 2004-2024.Orthopaedic surgery · 2025Article
- Effectiveness of epidural amniotic fluid injection for low back pain.Interventional pain medicine · 2025Article
- Role of macrophage in intervertebral disc degeneration.Bone research · 2025Review
- Exploring the impact of macrophage polarization and Modic changes on baseline clinical condition in radiculopathy due to lumbar disc herniation.Brain & spine · 2025Article
- Preclinical development and characterisation of PP353, a formulation of linezolid for intradiscal administration.JOR spine · 2024Article
- Can Hematological Inflammatory Indices Be Used to Differentiate Modic Type 1 Changes from Brucella Spondylodiscitis?Medicina (Kaunas, Lithuania) · 2024Article
- Chronic Low Back Pain: History, Symptoms, Pain Mechanisms, and Treatment.Life (Basel, Switzerland) · 2024Review
- Physiotherapeutic and non-conventional approaches in patients with chronic low-back pain: a level I Bayesian network meta-analysis.Scientific reports · 2024Article
- Efficacy of stepped care treatment for chronic discogenic low back pain patients with Modic I and II changes.Interventional pain medicine · 2023Article
Corrections and comments
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Authors and funding
4 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEstimating the contribution of endplate oedema known as Modic changes to lower back pain (LBP) has been the subject of multiple observational studies and reviews, some of which conclude that the evidence for an association of Modic change with LBP is uncertain while others demonstrate a clear link. The clinical trials demonstrating the benefit of basivertebral nerve ablation, a therapeutic intervention, in a tightly defined homogenous patient group with chronic LBP and Modic changes type 1 or type 2, provides further evidence for the contribution of Modic changes to LBP and shows that in these subjects, nerve ablation substantially reduces pain and disability. These interventional studies provide direct evidence that Modic changes can be associated with lower back pain and disability. This review set out to explore why the literature to date has been conflicting.
methodsA narrative, forensic, non-systematic literature review of selected articles to investigate why the published literature investigating the association between Modic imaging changes and chronic low back pain is inconsistent.
resultsThis review found that previous systematic reviews and meta-analyses included both heterogeneous study designs and diverse patient syndromes resulting in an inconsistent association between Modic changes and nonspecific chronic lower back pain. Re-analysis of literature data focussing on more homogenous patient populations provides clearer evidence that Modic changes are associated with nonspecific chronic lower back pain and that type 1 Modic changes are more painful than type 2.
conclusionsStudies using tightly defined homogenous patient groups may provide the best test for association between MRI-findings and pain and disability. Clinical benefit of basivertebral nerve ablation observed in randomised controlled trials further supports the association between type 1 and type 2 Modic changes with pain and disability.
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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.