La discopathie active

Abstract

Modic et al. description of vertebral endplate magnetic resonance imaging (MRI) signal changes associated with degenerative disk disease in the late 1980s, along with recent studies, suggest that among non-specific chronic low back pain (cLBP) patients, some subgroups could be further individualized based on their clinical, radiological and biological features, giving raise to the concept of “active discopathy”. This concept designates a syndrome, which has allowed, for the first time, to link a particular phenotype of cLBP patients with an anatomical lesion, namely Modic 1 changes. Local inflammation is thought to play a pivotal role in the development of Modic 1 changes and of symptoms. However, underlying etiopathogenic mechanisms remain debated. Several hypotheses are proposed including infectious process, mechanical or biochemical stress, and predisposing genetic factors. Treatment strategies remain controversial and depend on which etiopathogenic hypothesis is privileged.