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The mean time between previous intervention and intradiscal injection was 2.6?��?0.7 years in Modic I-b group and 1.4?��?0.8 in controls. In the total population, the injected levels were L2-L3 in 4 cases, L3-L4 in 2, L4�CL5 in 44, and L5-S1 in 47 and did not differ among groups. Data were available for short-term (24-h) assessment for 95 patients (30 Modic I-a, 35 Modic I-b, 30 controls) and for long-term assessment for 77 (26 Modic I-a, 36 Modic I-b 15 controls). The drop out rate was therefore 2% at short-term assessment (Modic I-a 0%, Modic I-b 5%, controls 0%) and 21% at long-term assessment (Modic I-a 13%, Modic I-b 3%, controls 50%). The mean long-term follow-up was 14?��?2 months in Modic I-a, 14?��?1 in Modic I-b and 12?��?2 in Control. It did not differ among groups. Twenty-four hours after injection, [http://www.selleckchem.com/products/mi-773-sar405838.html SAR405838] the proportion of patients with self-assessed improvement was significantly higher for Modic I-a and Modic I-b groups than for controls: Modic [http://www.selleckchem.com/products/lee011.html LEE011 manufacturer] I-a, 27 patients (90%); Modic I-b, 25 patients (71%); Control, nine patients (30%) (Fig. 1), with no difference between Modic I-a and Modic I-b groups. Both groups experienced a significant decrease from baseline in level of low back pain (Modic I-a, 52?��?5 vs. 28?��?5?mm; Modic I-b, 62?��?4 vs. 37?��?5?mm; P?[http://en.wikipedia.org/wiki/Resiquimod Resiquimod] for Modic I-a and Modic I-b groups than for controls at 24?h. At the last follow-up, patients did not differ in self-assessed improvement (Fig. 1) or in changes from baseline in level of low back pain (Fig. 2) or radiating pain (Fig. 3). Our results indicate an acute short-term (24-h) reduction in pain with intradiscal injection of corticosteroids in severe, disabling chronic low back pain associated with Modic type 1 MRI signals. Interestingly, this effect was not observed in patients with chronic low back pain without evidence of Modic type 1 MRI signals. Our results add to the evidence of low back pain associated with Modic 1 changes. Revel et al. first suggested a specific clinical profile of such patients [27]. Patients with Modic type 1 changes seen on MRI were described as experiencing severe worsening of chronic low back pain, and a high proportion reported increased pain during late night and morning [26]. Biological findings agree with the clinical inflammatory profile. Patients with chronic low back pain and Modic type 1 changes show increased serum level of high-sensitivity C-reactive protein. As well, increased expression of tumor necrosis factor alpha in vertebral end plates has been reported [22]. Despite this profile, patients show no further evidence of spondylarthropathy [26].