System Maintenance Notice

Please note that maintenance work is scheduled between 4 AM and 5 AM - CET. During this time, you may experience reduced performance. Thanks for your patience.

Publications

Journal Article Epublish

PubMed: 42893279 DOI: 10.22603/ssrr.2026-0057

Relationship between Lumbar Spinal Movement and the Location of Type 1 Modic Changes in Elite Athletes.

Spine Surg Relat Res 10(5):741-750

Authors: Saori Soeda, Masatoshi Morimoto, Takafumi Ohshima, Junzo Fujitani, Takayuki Kitahara, Daiki Nakajima, Naoto Ono, Yuji Nagao, Kosuke Sugiura, Hiroaki Manabe, Fumitake Tezuka, Sudharshan Tripathi, Koichi Sairyo

Affiliations

  • Department of Orthopedics, Tokushima University, Tokushima, Japan.
  • Departments of Bioengineering and Orthopaedics, Engineering Center for Orthopaedic Research Excellence, University of Toledo, Toledo, Ohio, USA.

Abstract

INTRODUCTION

Type 1 Modic change (MC1) is strongly associated with chronic low back pain, but it is unclear whether its anatomical distribution reflects sport-specific spinal loading in elite athletes.

METHODS

We retrospectively reviewed elite athletes with chronic low back pain and magnetic resonance imaging (MRI)-confirmed MC1 who had a history of low back pain for >3 months and concordant pain relief after fluoroscopy-guided discography or selective disc block at the MC1 level. Athletes aged >60 years and those with a history of lumbar surgery, scoliosis >10°, or sagittal translation >4 mm were excluded. Three blinded reviewers classified the dominant spinal movement of each athlete during competition (flexion, extension, right/left lateral bending, or axial loading). The distribution pattern of MC1 (anterior, posterior, right, left, or entire) was determined on short-tau inversion recovery MRI scans. Correspondence was assessed only when all reviewers agreed on the dominant movement.

RESULTS

Eighteen athletes (19 levels) with a mean age of 34.5 years were included. MC1 (63%) was most frequently observed at L5-S1. MC1 was localized anteriorly in 42%, to the right in 26%, to the left in 16%, and involved the entire endplate in 16%. There were no posterior-only lesions. Rater consensus on the dominant movement was obtained for 10 athletes (involved in seven sports). Nine of these 10 athletes (90%) showed correspondence between the dominant movement and the distribution of MC1, including flexion with anterior MC1 and right lateral bending with right-sided MC1.

CONCLUSIONS

Sports with a single dominant repetitive spinal movement often showed a match between that movement and the location of MC1. This finding supports a focal, load-related mechanism linking sport-specific spinal loading with MC1 in elite athletes with chronic low back pain.

MeSH

Low Back Pain, Pain, Magnetic Resonance Imaging, Back Pain, History, Athletes, Movement, Sports, Spine