Top

Published in:

Open Access 01-04-2011 | Case Report

Modic type I changes of the lumbar spine in golfers

Authors: Jason Mefford, Koichi Sairyo, Toshinori Sakai, Justin Hopkins, Madoka Inoue, Rui Amari, Nitin N. Bhatia, Akira Dezawa, Natsuo Yasui

Published in: Skeletal Radiology | Issue 4/2011

Abstract

Low back pain (LBP) is the most prevalent musculoskeletal complaint among professional and amateur golfers; however, associated radiological changes in golf-related LBP have not been examined in the literature. We suspect that Modic Type 1 changes in the lumbar spine are linked to golf-related LBP. In this retrospective case series, four middle-aged golfers (one professional and three high-level amateurs) presented to our clinic with LBP. Inflammation of the right side of endplates in the lumbar spine was suspected based on Modic Type 1 changes detected by magnetic resonance imaging (MRI) in each patient. All four cases were diagnosed with right-sided endplate inflammation and administered intradiscal steroid injections with a non-steroidal anti-inflammatory drug (NSAID). Treatment swiftly alleviated LBP and diminished Modic Type 1 changes on follow-up MRI 3–6 months later in all four patients. We suggest that Modic Type 1 changes play a significant role in the diagnosis and treatment of golf-related LBP.

National Golf Foundation Questions/FAQs. Available at: http://www.ngf.org/cgi/whofaqa.asp. 2010; Accessed July 29.

McCarroll JR. The frequency of golf injuries. Clin Sports Med. 1996;15(1):1–7.PubMed

McCarroll JR. Overuse injuries of the upper extremity in golf. Clin Sports Med. 2001;20(3):469–79.PubMedCrossRef

McCarroll JR, Gioe TJ. Professional golfers and the price they pay. Physician Sportsmed. 1982;10:64–70.

Batt ME. A survey of golf injuries in amateur golfers. Br J Sports Med. 1992;26:63–5.PubMedCrossRef

Batt ME. Golfing injuries. An overview. Sports Med. 1993;16(1):64–71.PubMedCrossRef

McCarroll JR, Rettig AC, Shelbourne KD. Injuries in the amateur golfer. Phys Sportsmed. 1990;18(3):122–6.

Stover CN MJ, Mallon WJ. Feeling up to par: medicine from tee to green. Philadelphia: FA Davis; 1994.

Hosea TM, Gatt CJ. Back pain in golf. Clin Sports Med. 1996;15(1):37–53.PubMed

10.

Adams MA, Freeman BJC, Morrison HP, et al. Mechanical initiation of intervertebral disc degeneration. Spine (Phila Pa 1976). 2000;25(13):1625–36.

11.

Modic MT, Steinberg PM, Ross JS, et al. Degenerative disk disease - Assessment of changes in vertebral body marrow with MR imaging. Radiology. 1988;166(1):193–9.PubMed

12.

Albert H, Manniche C. Modic changes following lumbar disc herniation. Eur Spine. 2007;16(7):977–82.CrossRef

13.

Braithwaite I, White J, Saifuddin A, et al. Vertebral end-plate (Modic) changes on lumbar spine MRI: correlation with pain reproduction at lumbar discography. Eur Spine. 1998;7(5):363–8.CrossRef

14.

Cvitanic OA, Schimandle J, Casper GD, et al. Subchondral marrow changes after laser diskectomy in the lumbar spine: MR Imaging findings and clinical correlation. AJR Am J Roentgenol. 2000;174(5):1363–9.PubMed

15.

Ito M, Incorvaia KM, Yu SF, et al. Predictive signs of discogenic lumbar pain on magnetic resonance imaging with discography correlation. Spine (Phila Pa 1976). 1998;23(11):1252–8.

16.

Kuisma M, Karppinen J, Niinimäki J, et al. Modic changes in endplates of lumbar vertebral bodies: prevalence and association with low back and sciatic pain among middle-aged male workers. Spine (Phila Pa 1976). 2007;32(10):1116–22.

17.

Schenk P, Läubli T, Hodler J, et al. Magnetic resonance imaging of the lumbar spine: findings in female subjects from administrative and nursing professions. Spine (Phila Pa 1976). 2006;31(23):2701–6.

18.

Weishaupt D, Zanetti M, Hodler J, et al. Painful lumbar disk derangement: relevance of endplate abnormalities at MR imaging. Radiology. 2001;218(2):420–7.PubMed

19.

Modic MT, Masaryk TJ, Ross JS, et al. Imaging of degenerative disk disease. Radiology. 1988;168(1):177–86.PubMed

20.

Adlington GS. Proper swing technique and biomechanics of golf. Clin Sports Med. 1996;15(1):9–26.PubMed

21.

Pink M, Perry J, Jobe FW. Electromyographic analysis of the trunk in golfers. Am J Sports Med. 1993;21(3):385–8.PubMedCrossRef

22.

Watkins RG, Uppal GS, Perry J, et al. Dynamic electromyographic analysis of trunk musculature in professional golfers. Am J Sports Med. 1996;24(4):535–8.PubMedCrossRef

23.

Theriault G, Lachance P. Golf injuries - An overview. Sports Med. 1998;26(1):43–57.PubMedCrossRef

24.

Jinkins JR, Van Goethem JWM. The postsurgical lumbosacral spine - Magnetic resonance imaging evaluation following intervertebral disk surgery, surgical decompression, intervertebral bony fusion, and spinal instrumentation. Radiol Clin North Am. 2001;39(1):1–29.PubMedCrossRef

25.

Tehranzadeh J, Andrews C, Wong E. Lumbar spine imaging. Normal variants, imaging pitfalls, and artifacts. Radiol Clin North Am. 2000;38(6):1207–53.PubMedCrossRef

26.

Ohtori S, Inoue G, Ito T, et al. Tumor necrosis factor-immunoreactive cells and PGP 9.5-immunoreactive nerve fibers in vertebral endplates of patients with discogenic low back pain and Modic Type 1 or Type 2 changes on MRI. Spine (Phila Pa 1976). 2006;31(9):1026–31.

27.

Weishaupt D, Zanetti M, Hodler J, et al. MR imaging of the lumbar spine: Prevalence of intervertebral disk extrusion and sequestration, nerve root compression, end plate abnormalities, and osteoarthritis of the facet joints in asymptomatic volunteers. Radiology. 1998;209(3):661–6.PubMed

28.

Gosheger G, Liem D, Ludwig K, et al. Injuries and overuse syndromes in golf. Am J Sports Med. 2003;31(3):438–43.PubMed

29.

McHardy A, Pollard H, Lu K. Golf injuries: A review of the literature. Sports Med. 2006;36(2):171–87.PubMedCrossRef

Title: Modic type I changes of the lumbar spine in golfers
Authors: Jason Mefford
Koichi Sairyo
Toshinori Sakai
Justin Hopkins
Madoka Inoue
Rui Amari
Nitin N. Bhatia
Akira Dezawa
Natsuo Yasui
Publication date: 01-04-2011
Publisher: Springer-Verlag
Published in: Skeletal Radiology / Issue 4/2011
Print ISSN: 0364-2348
Electronic ISSN: 1432-2161
DOI: https://doi.org/10.1007/s00256-010-1066-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Modic type I changes of the lumbar spine in golfers

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 4/2011

Synovial plicae of the hip: evaluation using MR arthrography in patients with hip pain

A systematised MRI approach to evaluating the patellofemoral joint

Lower back pain after recently giving birth

Magnetic resonance imaging of intramuscular metastases

Lower back pain after recently giving birth: postpartum sacral stress fractures

Acute inversion injury of the ankle without radiological abnormalities: assessment with high-field MR imaging and correlation of findings with clinical outcome