2024 Volume 15 Issue 6 Pages 827-832
Background: Chronic low back pain in athletes often involves Type 1 Modic changes and it is reported that one of the causes of Modic changes are mechanical stress from repeated spinal movement. However, there are no reports that analyzed specific spinale movements affecting the location where MRI signal changes occur. This study aims to analyze whether the signal change of Type 1 Modic changes in elite athletes will be associated with sports-specific spinal loading.
Methods: We first biomechanically analyzed the high-stress points during various spinal movements with a 3-dimensional lumbar spine finite element model. Clinically, patient charts with chronic low back pain and diagnosed with Type 1 Modic changes were reviewed, collecting data on age, sport type, Cobb angle, slippage distance on flexion lumbar X-rays and Short Tau Inversion Recovery Magnetic Resonance Imaging (STIR MRI) findings. Type 1 Modic change distribution was classified based on sagittal STIR MRI into "Anterior, " "Posterior, " "Right, " "Left, " and "Entire. "
Results: The finite element spine model showed higher stress on the bent side. Based on the Type 1 Modic distribution in athletes showed specific patterns: 5 intervertebral (29%) in the Anterior group, 6 (35%) in the Right group, and 2 (12%) in the Left group and 4 (24%) in the Entire group, no patients belonged to the Posterior group. All sports involved repetitive spinal movements strongly suspected of exerting stress on the Type 1 Modic-affected side.
Conclusion: The results were consistent with the hypothesis that specific movements during play affect the location of signal changes, leading to sports-specific laterality. However, sports movements are intricate, necessitating consideration of both the frequency of particular movements and the effects of other motions on stress.
