The effect of long-term alendronic acid treatment on Modic changes in the lumbar spine: a gender and age-matched study.

J Orthop Surg Res

Department of Orthopaedics and Traumatology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong.

Published: May 2024

AI Article Synopsis

  • Oral alendronic acid was studied for its potential effects on Modic changes (MCs) and low back pain (LBP) in adults, compared to a control group not receiving any anti-osteoporotic medication.
  • The study involved 82 subjects, with 41 receiving the medication for at least a year, and MRI results showed a significantly lower prevalence and severity of MCs in the treatment group.
  • Findings suggest that oral alendronic acid may help reduce MC-related low back pain in individuals also suffering from osteoporosis.

Article Abstract

Background: Low back pain (LBP) affects a significant proportion of the adult population. Potent anti-resorptive drugs such as intravenous zoledronic acid have been demonstrated to reduce Modic changes (MCs) upon magnetic resonance imaging (MRI) of the spine and concomitantly decrease associated LBP. It is uncertain whether oral alendronic acid has a similar effect.

Methods: 82 subjects were recruited in this case-control study. Treatment subjects (n = 41) received oral alendronic acid treatment for at least 1-year and were matched by gender and age (± 2) to control subjects (n = 41) not receiving any anti-osteoporotic medication. The prevalence, type, and extent of MCs were quantified upon T1 and T2-weighted MRIs of the lumbosacral spine.

Results: Treatment subjects received oral alendronic acid for 124.0 ± 62.1 weeks at the time of MRI assessment and exhibited a lower prevalence of MCs over the lumbosacral spine (18/41 vs. 30/41, p < 0.001) as compared to control subjects. Amongst both groups, type 2 MCs were predominant. Quantification of type 2 MCs in treatment subjects revealed a significant reduction in area (113 ± 106 mm vs. 231 ± 144 mm, p < 0.01) and volume (453 ± 427 mm vs. 925 ± 575 mm, p < 0.01) affected by type 2 MCs in comparison to matched controls.

Conclusion: Oral alendronic acid may be useful in the treatment of MC-associated LBP in patients with concomitant osteoporosis.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11089688PMC
http://dx.doi.org/10.1186/s13018-024-04780-2DOI Listing

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