Table 7 Studies examining the relationship between the presence of low virulent bacteria and modic changes
From: Could low grade bacterial infection contribute to low back pain? A systematic review
Studies | Study design | Demographics N (% Female) Mean age (years) | Clinical features | Measure of modic change | Results | Quality score |
|---|---|---|---|---|---|---|
Albert [1] | Randomised controlled trial | Treatment group: | Chronic LBP (>6 months) occurring after a previous disc herniation and who also had Modic type 1 changes in the vertebrae adjacent to the previous herniation | Type, size, and volume graded according to the Nordic Modic Protocol | Modic changes: Treatment group: 142 (92.2%) | 100 |
90 (58.2% F) | Placebo group: 130 (97%) | |||||
Grade 1 Modic changes: Treatment group: 10.4%; Placebo group: 28.8% | ||||||
Age: 44.7 (10.3) | P = 0.006 | |||||
Placebo group: | At 1-year follow-up, 10 patients in both groups demonstrated no Modic changes | |||||
72 (58.2% F) | ||||||
Treatment group: Significant decrease in volume; volume 2–4 were reduced to volume 1 (P = 0.05) | ||||||
Age: 45.5 (9.2) | Placebo group: Not observed | |||||
Albert [2] | Cohort | 61 (27% F) | Disc herniation | Type, size, and volume graded according to the Nordic Modic Protocol | Discs (anaerobic bacteria): 80% developed new Modic changes in the vertebrae adjacent to the previous disc herniation. Discs (Aerobic): No new; MC discs (negative cultures): 44% new MC | 78 |
Age: 46.4 | ||||||
The association between an anaerobic culture and new MCs was significant | ||||||
5.60 (95% CI 1.51–21.95), (P = 0.004) | ||||||
Arndt [9] | Cross-sectional | 83 (59% F) | Disc degeneration | Modic changes (Type 1 and 2) | There was no significant association between Modic changes and positive cultures (P = 0.2) | 67 |
Age: 41 | ||||||
Wedderkopp [15] | Cross-sectional | 24 (58% F) | No clinical symptoms; Modic type I changes in at least 1 vertebra | Type 1 Modic changes only | There was no evidence of bacteria in vertebrae with Modic type 1 changes, with only 2/24 patients yielding bacteria. | 67 |
Age: 43 (NA) |