Skip to main content

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)