Many of my patients have seen some research from Denmark reported recently in the Guardian newspaper.The original research is published in the European Spine Journal vol 22 Issue 4 p 690-696.To explain further: this suggests that 80% of patients with modic changes (high signal in the endplates adjacent to the disc- believed to be representative of bone oedema) on MRI scan at the time of discectomy had a bacterial infection of the disc. 40% of patients without modic type I changes had the same bacteria seen in the disc samples. This is an interesting observation.There have been many attempts to link Modic change with back pain over the years that have been contradictory. However what we do know for certain is that not all patients with Modic type I changes have back pain, and not all patients with back pain have Modic changes!
The situation is therefore complicated, and it remains to be seen what proportion of patients in what specific circumstances may benefit from this new research.