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European Spine Journal

, Volume 7, Issue 5, pp 363–368 | Cite as

Vertebral end-plate (Modic) changes on lumbar spine MRI: correlation with pain reproduction at lumbar discography

  • I. Braithwaite
  • J. White
  • A. Saifuddin
  • P. Renton
  • B. A. Taylor
Original article

Abstract

The vertebral end-plate has been identified as a possible source of discogenic low back pain. MRI demonstrates end-plate (Modic) changes in 20–50% of patients with low back pain. The aim of this study was to investigate the association between Modic changes on MRI and discogenic back pain on lumbar discography. The MRI studies and discograms of 58 patients with a clinical diagnosis of discogenic back pain were reviewed and the presence of a Modic change was correlated with pain reproduction at 152 disc levels. Twenty-three discs with adjacent Modic changes were injected, 21 of which were associated with pain reproduction. However, pain was also reproduced at 69 levels where no Modic change was seen. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for a Modic change as a marker of a painful disc were 23.3%, 96.8%, 91.3% and 46.5% respectively. Modic changes, therefore, appear to be a relatively specific but insensitive sign of a painful lumbar disc in patients with discogenic low back pain.

Key words Low back pain MRI Discography Vertebral end-plate 

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Copyright information

© Springer-Verlag Berlin Heidelberg 1998

Authors and Affiliations

  • I. Braithwaite
    • 1
  • J. White
    • 2
  • A. Saifuddin
    • 3
  • P. Renton
    • 3
  • B. A. Taylor
    • 1
  1. 1.Department of Spinal Surgery, The Royal National Orthopaedic Hospital Trust, Stanmore, Middlesex, UKGB
  2. 2.Department of Orthopaedic Surgery, University College London Hospitals, London, UKGB
  3. 3.Department of Radiology, The Royal National Orthopaedic Hospital Trust, Brockley Hill, Stanmore, Middlesex HA7 4LP, UK Tel.: +44-181-954 2300 ext 443, Fax: +44-181-954 0281GB

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