Maatta, Juhani1; Kautiainen, Hannu2; Taimela, Simo3; Niinimaki, Jaakko4; Jarvenpaa, Salme5; Koskelainen, Tatu6; Makela, Pirkka7; Pesala, Juha7; Kyllonen, Eero1; Cheung, Kenneth MC8; Karppinen, Jaro1
Author Information
1Institute of Clinical Sciences, University of Oulu, Department of Physical and Rehabilitation Medicine, Oulu, Finland; 2Central Finland Central Hospital, Unit of Family Practice, Jyvaskyla, Finland; 3University of Helsinki, Department of Public Health, Helsinki, Finland;4Institute of Diagnostics, University of Oulu, Department of Diagnostic Radiology, Oulu, Finland; 5Medcare Foundation, Aanekoski, Finland;6Institute of Clinical Sciences, University of Oulu, Department of Neurosurgery, Oulu, Finland; 7 Institute of Clinical Sciences, University of Oulu, Department of Surgery, Oulu, Finland; 8University of Hong Kong, Department of Orthopaedics and Traumatology, Hong Kong, China
INTRODUCTION: Modic changes (MC) are bone marrow and vertebral endplate lesions seen on magnetic resonance imaging (MRI). They are associated with low back pain (LBP). Health‐related quality of life (HRQoL) has been widely studied among patients with LBP, but the effect of MC on HRQoL is not known. We assessed the relationship between MC and HRQoL among patients referred to spine surgery.
METHODS: The subjects were 136 patients referred to lumbar spine surgery in Northern Finland. The HRQoL was assessed with RAND‐36 questionnaire. Lumbar MC were evaluated and classified into ‘No MC’, ‘Type I or I/II’, and ‘Type II, II/III or III’. Differences in HRQoL between groups were compared using analysis of covariance (ANCOVA). Post‐hoc testing of univariate comparisons was made with Sidak's test.
RESULTS: In total, 62 patients (46%) had MC. Of these 34% had type I or I/II and 66% type II, II/III or III. Patients with MC were older, more likely females, had longer duration of LBP, and had a higher degree of disc degeneration than patients without MC. The total mental component of RAND‐36 (P=0.020), and dimensions of energy (P=0.030) and emotional wellbeing (P=0.013) differed significantly between the groups after adjustments for age and gender, whereas the total physical component or physical dimensions did not differ significantly between the groups. In the mental dimension scores, a statistically significant difference was localized between ‘No MC’ and ‘Type II, II/III or III’ by pairwise comparisons. In the full model (adjustments for age, gender, duration of LBP and sum score of disc degeneration) no significant differences were observed but total mental component and emotional role functioning were of borderline significance (P=0.093 and 0.084, respectively).
DISCUSSION: MC may be associated with the mental status of HRQoL among patients referred to spine surgery.
© 2011 Lippincott Williams & Wilkins, Inc.
