Abstract
Since the introduction of MRI for the assessment of degenerative pathologies of the lumbar spine, the bone marrow changes adjacent to the vertebral endplates, as described by Modic in 1984, are well known: There are three types of changes, and this classification has been accepted internationally by radiologists and spine surgeons, i.e. orthopaedic surgeons, as well as neurosurgeons treating routinely degenerative disc disease. Jones et al and Mulconrey et al reported a kappa value of 0.85 and 0.7 respectively for the interobserver reliability of these bone marrow changes.
Similar content being viewed by others
References
BAUR-MELNYK A, TRIANTAFYLLOU M, BIRKENMAIER C ET AL (2006): DEGENERATIVE DISEASES OF THE SPINE: RARE AND OFTEN UNRECOGNISED CAUSES OF PAIN SYNDROMES. RADIOLOGE 46: 454–467
BENEKER LM, HEINI PF, ANDERSON SE ET AL (2005): CORRELATION OF RADIOGRAPHIC AND MRI PARAMETERS TO MORPHOLOGICAL AND BIOCHEMICAL ASSESSMENT OF INTERVERTEBRAL DISC DEGENERATION. EUR SPINE J 14: 27–35
BRAITHWAITE JI, WHITE J, SAIFUDDIN A ET AL (1998): VERTEBRAL END-PLATE (MODIC) CHANGES ON LUMBAR SPINE MRI: CORRELATION WITH PAIN REPRODUCTION AT LUMBAR DISCOGRAPHY. EUR SPINE J 7: 363–368
BUTTERMANN GR, EITHOFF KB, OGILVIE JW ET AL (1997): VERTEBRAL BODY MRI RELATED TO LUMBAR FUSION RESULTS. EUR SPINE J 6: 115–120
CARRAGEE EJ, ALAMIN TF, MILLER JL ET AL (2005): DISCOGRAPHIC, MRI AND PSYCHOSOCIAL DETERMINANTS OF LOW BACK DISABILITY AND REMISSION: A PROSPECTIVE STUDY IN SUBJECTS WITH BENIGN PERSISTENT BACK PAIN. SPINE J 5: 24–35
CHATAIGNER H, ONIMUS M, POLETTE A (1998): SURGERY FOR DEGENERATIVE LUMBAR DISC DISEASE. SHOULD THE BLACK DISC BE GRAFTED? REV CHIR ORTHOP REPARATRICE APPAR MOT 84: 583–589
CHUNG CB, VANDEBERG BC, TAVERNIER T ET AL (2004): END PLATE MARROW CHANGES IN THE ASYMPTOMATIC LUMBOSACRAL SPINE: FREQUENCY, DISTRIBUTION AND CORRELATION WITH AGE AND DEGENERATIVE CHANGES. SKELET RADIOL 33: 399–404
DE ROOS A, KRESSEL H, SPRITZER C ET AL (1987): MR IMAGING OF MARROW CHANGES ADJACENT TO ENDPLATES IN DEGENERATIVE LUMBAR DISC DISEASE. AJR AM J ROENTGENOL 149: 531–534
ELSIG JP, KAECH DL (2007): DYNAMIC IMAGING OF THE SPINE WITH AN OPEN UPRIGHT MRI: PRESENT RESULTS AND FUTURE PERSPECTIVES OF FMRI. EUR J ORTHOP SURG TRAUMATOL 17: 119–124
ESPOSITO P, PINHEIRO-FRANCO JL, FROEHLICH S ET AL (2006): PREDICTIVE VALUE OF MRI VERTEBRAL END-PLATE SIGNAL CHANGES (MODIC) ON OUTCOME OF SURGICALLY TREATED DEGENERATIVE DISC DISEASE. RESULTS OF A COHORT STUDY INCLUDING 60 PATIENTS. NEUROCHIRURGIE 52: 315–322
JARVIK JG, HOLLINGWORTHW, HEAGERTY PJ ET AL (2005): THREE-YEAR INCIDENCE OF LOW BACK PAIN IN AN INITIALLY ASYMPTOMATIC COHORT; CLINICAL AND IMAGING RISK FACTORS. SPINE 30: 1541–1548
JONES A, CLARKE A, FREEMAN B ET AL (2005): THE MODIC CLASSIFICATION: INTER-AND INTRAOBSERVER ERROR IN CLINICAL PRACTICE. SPINE 30: 1867–1869
JUDMAIER W, ZUR NEDDEN D (1994): MRI IN DEGENERATIVE AND POSTTRAUMATIC CHANGES OF THE SPINE. ORTHOPAEDE 23: 306–312
KANEMOTO M, HUKUDA S, KOMIYA Y ET AL (1996): IMMUNHISTOCHEMICAL STUDY MATRIX METALLOPROTEINASE-3 AND TISSUE INHIBITOR OF METALLOPROTEINASE-1 HUMAN INTERVERTEBRAL DISCS. SPINE 21: 1–8
KANG JT, GEORGESCU HI, MCINTYRE-LARKIN L ET A (1996): HERNIATED LUMBAR INTERVERTEBRAL DISKS SPONTANEOUSLY PRODUCE MATRIX METALLOPROTEINASES, NITRIC OXIDE, INTERLEUKIN-6 AND PROSTAGLANDIN E2. SPINE 21: 271–277
KARSHEVSKI M, SCHWEITZER ME, CARRINOJA ET AL (2005): REACTIVE ENDPLATE MARROW CHANGES: A SYSTEMATIC MORPHOLOGIC AND EPIDEMIOLOGIC EVALUATION. SKELETAL RADIOL 34: 125–129
KJAER P, LEBOEUF C, SORENSEN JS ET AL (2005): AN EPIDEMIOLOGIC STUDY OF MRI AND LOW BACK PAIN IN 13-YEARS OLD CHILDREN. SPINE 30: 798–806
KJAER P, LEBOEUF C, KORSHOLM L ET AL (2005): MAGNETIC RESONANCE IMAGING AND LOW BACK PAIN IN ADULTS: A DIAGNOSTIC IMAGING STUDY OF 40-YEAR-OLD MEN AND WOMEN. SPINE 30: 1173–1180
KJAER P, KORSHOLM L, BENDIX T ET AL (2006): MODIC CHANGES AND THEIR ASSOCIATIONS WITH CLINICAL FINDINGS. EUR SPINE J 15: 1312–1319
KUISMA M, KAPINNEN J, NIINIMÄKI J ET AL (2006): A THREE-YEAR FOLLOW-UP OF LUMBAR SPINE ENDPLATE (MODIC) CHANGES. SPINE 31: 1714–1718
LAM KS (2008): REVIEWERS COMMENT ON “MRI FOLLOW-UP OF SUBCHONDRAL SIGNAL ABNORMALITIES IN A SELECTED GROUP OF CHRONIC LOW BACK PAIN PATIENTS”. EUR SPINE J 17: 1309–1310
LUOMA K, VEHMAS T, GRÖNBLAD M ET AL (2008): MRI FOLLOW-UP OF SUBCHONDRAL SIGNAL ABNORMALITIES IN A SELECTED GROUP OF CHRONIC LOWBACK PAIN PATIENTS. EUR SPINE J 17: 1300–1308
MARSHMAN LG, TREWHELLA M, FRIESEM T ET AL (2007): REVERSE TRANSFORMATION OF MODIC TYPE 2 CHANGES TO MODIC TYPE 1 CHANGES DURING SUSTAINED CHRONIC LOW BACK PAIN SEVERITY. J NEUROSURG SPINE 6: 152–155
MITRA D, CASSAR-PULLICINO VN, MCCALL IW (2004): LONGITUDINAL STUDY OF VERTEBRAL TYPE 1 END-PLATE CHANGES ON MR OF THE LUMBAR SPINE. EUR RADIOL 14: 1574–1581
MODIC MT, PAVLICEK W, WEINSTEN MA ET Al (1984): MAGNETIC RESONANCE IMAGING OF INTERVERTEBRAL DISK DISEASE. RADIOLOGY 152: 103–111
MODIC MT, STEINBERG PM, ROSS JS ET AL (1998): DEGENERATIVE DISK DISEASE: ASSESSMENT OF CHANGES IN VERTEBRAL BODY MARROW WITH MR IMAGING. RADIOLOGY 166: 193–199
MODIC MT, MASARYK TJ, ROSS JS ET AL (1988): IMAGING OF DEGENERATIVE DISK DISEASE. RADIOLOGY 168: 177–186
MODIC MT, ROSS JS (1991): MAGNETIC RESONANCE IMAGING IN THE EVALUATION OF LOW BACK PAIN. ORTHOP CLIN NORTH AM 22: 283–301
MODIC MT (2007): MODIC TYPE I AND TYPE 2 CHANGES, EDITORIAL. J NEUROSURG SPINE 6: 150–151
MULCONREY DS, KNIGHT RQ, BRAMLE JD ET AL (2006): INTEROBSERVER RELIABILITY IN THE INTERPRETATION OF DIAGNOSTIC LUMBAR MRI AND NUCLEAR IMAGING. SPINE J 6: 177–184
NEAL CJ, ROSNER MK, KUKLO TR (2005): MAGNETIC RESONANCE IMAGING EVALUATION OF ADJACENT SEGMENTS AFTER DISC ARTHROPLASTY. J NEUROSURG SPINE 3: 342–347
OHTORI S, INOE G, ITO T ET AL (2006): TUMOR NECROSIS FACTOR-IMMUNOREACTIVE CELLS AND PGP 9,5-IMMUNOREACTIVE NERVE FIBERS IN VERTEBRAL ENDPLATES OF PATIENTS WITH DISCOGENIC LOW BACK PAIN AND MODIC TYPE 1 OR TYPE 2 CHANGES ON MRI. SPINE 31: 1026–1031
ROSS JS (1991): MAGNETIC RESONANCE IMAGING OF THE POSTOPERATIVE SPINE. DEGENERATIVE DISC DISEASE. RADIOL CLIN NORTH AM 29: 793–808
SCHMID G, WITTELER A, WILLBURGER R ET AL (2004): LUMBAR DISK HERNIATION: CORRELATION OF HISTOLOGICAL FINDINGS WITH MARROW SIGNAL INTENSITY CHANGES IN VERTEBRAL ENDPLATES AT MR IMAGING. RADIOLOGY 231(2): 352–358
SIEPE CJ, MAYER HM, WIECHERT K ET AL (2006): CLINICAL RESULTS OF TOTAL LUMBAR DISC REPLACEMENT WITH PRODISC II: THREE-YEAR RESULTS FOR DIFFERENT INDICATIONS. SPINE 31: 1923–1932
TOYONE T, TAKAHISHI K, KITAHARA H ET AL (1994): VERTEBRAL BONE-MARROW CHANGES IN DEGENERATIVE LUMBAR DISC DISEASE. AN MRI STUDY OF 74 PATIENTS WITH LOW BACK PAIN. J BONE JOINT SURG BR 76: 757–764
VITAL JM, GILLE O, POINTILLART V ET AL (2003): COURSE OF MODIC 1 SIX MONTHS AFTER LUMBAR POSTERIOR OSTEOSYNTHESIS. SPINE 28: 715–720
VITAL JM (2003): INTÉRÊT DU SIGNAL DE MODIC I EN PATHOLOGIE LOMBAIRE DÉGÉNÉRATIVE. RACHIS 15: 257–258
VITAL JM, BENCHIKH-EL-FEGOUN A (2007): PARACLINICAL WORKUP, IN: VITAL JM (ED) ALTERNATIVES À L’ARTHRODÈSE LOMBO-SACRÉE. CAHIERS D’ENSEIGNEMENTS DE LA SOFCOT 96, ELSEVIER MASSON: 51–61
VITZTHUM HE (2000): DYNAMIC EXAMINATION OF THE LUMBAR SPINE USING THE VERTICAL OPEN MR. J NEUROSURG SPINE 93: 58–64
WEISHAUPT D, ZANETTI M, HODLER J ET AL (1998): MR IMAGING OF THE SPINE: PREVALENCE OF INTERVERTEBRAL DISC EXTRUSION AND SEQUESTRATION, OSTEOARTHRITIS OF THE FACET JOINT IN ASYMPTOMATIC VOLUNTEERS. RADIOLOGY 209: 661–666
ZHANGYH, ZHAO CQ, JIANG LS ET AL (2008): MODIC CHANGES: A SYSTEMATIC REVIEW OF THE LITERATURE. EUR SPINE J 17: 1289–1299
Author information
Authors and Affiliations
Additional information
No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.
Rights and permissions
About this article
Cite this article
Vitzthum, H.E., Kaech, D.L. Modic changes in patients with degenerative diseases of the lumbar spine. ArgoSpine News J 21, 57–61 (2009). https://doi.org/10.1007/S12240-009-0012-4
Published:
Issue Date:
DOI: https://doi.org/10.1007/S12240-009-0012-4