Clinical trial NCT05022017: Description of Statics by EOS Imaging and Evaluation of the Efficacy of Intradiscal Corticosteroid Infiltration
Official title: EOS MODIC : Inflammatory Disc Disease: Description of Statics by EOS Imaging and Evaluation of the Efficacy of Intradiscal Corticosteroid Infiltration
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Inflammatory Disease
Lead sponsor: Fondation Hôpital Saint-Joseph
Sponsor class: OTHER
First posted: 2021-08-26
Enrollment: 100
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: RETROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Patient hospitalized in the rheumatology department of GHPSJ between 01/01/2014 and 31/12/2020 for MODIC 1

Brief summary: Inflammatory disc disease or Modic 1 disc disease is a radiological entity first described by Modic in 1988 and corresponds to an inflammatory signal on MRI defined by the presence of a T2-weighted hypersignal and a T1-weighted hyposignal of the vertebral endplates adjacent to a pathological disc.

The presence of these radiological abnormalities are significantly associated with chronic low back pain, the therapeutic management of which may include lumbar rehabilitation, rigid corset, spinal infiltrations and surgical treatment. Corticosteroid infiltration of the pathological intervertebral disc (intradiscal infiltration) has been evaluated in low back pain due to Modic 1 disc disease with short-term efficacy. The clinical response to this infiltration is not always optimal and to date in the literature, no predictive factor of response has been identified.

Detailed description: There are several hypotheses to explain this phenomenon: mechanical, genetic, infectious or inflammatory. One of the mechanical hypotheses would be the presence of an instability of the spinal segment (hypermobility of the spinal segment) and disorders of the sagittal statics of the spine with angles of thoracic kyphosis and lumbar lordosis weak and a weak sacral slope supporting a hyperpressure passing by the discs and the genesis of discopathy.

In this work, the investigators will evaluate the different parameters of the spinal statics in the sagittal plane and in the frontal plane (sacral slope, pelvic version, Roussouly classification, cobb angle...) by EOS imaging as well as the parameters of the Modic 1 anomaly on lumbar MRI (spinal stage, Pfirmann classification, laterality of the inflammatory signal) in a population of patients who received intradiscal corticosteroid infiltration for low back pain in the context of Modic 1 disc disease.

The analysis of the different radiological parameters could enrich the investigator's understanding of the pathophysiology and evaluate radiological factors predictive of the effectiveness of intradiscal infiltration in this population. This could allow us to adapt the management of low back pain patients with Modic 1 disc disease.

Eligibility criteria: Inclusion Criteria:

* Patient whose age ≥ 18 years
* French speaking patient
* Patient hospitalized in the rheumatology department of GHPSJ between 01/01/2014 and 31/12/2020 for MODIC 1
* Patients who received as part of their management an intra-disc infiltration with hydrocortancyl.

Exclusion Criteria:

* Patient under guardianship or curators
* Patient deprived of liberty
* Patient under court protection
* Patient objecting to the use of his data for this research
* Patient having benefited from another infiltration between the intradiscal infiltration and the collection of efficacy data at 3 months.

Primary outcomes:
measure: Evaluate the effectiveness of the intra-disc infiltration at 3 months on the pain felt by the patient.
timeFrame: 3 months
Secondary outcomes:
measure: Change in analgesic consumption (Level 1, Level 2, Level 3 and NSAIDs) at 3 months.
timeFrame: 3 months
measure: Describe the parameters of spinal statics in the frontal planes in Modic 1 disc disease.
timeFrame: 3 months
measure: Compare the parameters of spinal statics according to the different stages of Modic 1 disc disease
timeFrame: 3 months
measure: Predictive factors (clinical and radiological) of the effectiveness of intra-disc infiltration
timeFrame: 3 months
Other outcomes:
Locations:
city: Paris
country: France
facility: Groupe Hospitalier Paris Saint Joseph
state: Ile-de-France
Study officials:
affiliation: Fondation Hôpital Saint-Joseph
name: Thomas HUET, MD
role: PRINCIPAL_INVESTIGATOR
References: