Abstract
The prevalence of “vertebral endplate signal changes” (VESC) and its association with low back pain (LBP) varies greatly between studies. This wide range in reported prevalence rates and associations with LBP could be explained by differences in the definitions of VESC, LBP, or study sample. The objectives of this systematic critical review were to investigate the current literature in relation to the prevalence of VESC (including Modic changes) and the association with non-specific low back pain (LBP). The MEDLINE, EMBASE, and SveMED databases were searched for the period 1984 to November 2007. Included were the articles that reported the prevalence of VESC in non-LBP, general, working, and clinical populations. Included were also articles that investigated the association between VESC and LBP. Articles on specific LBP conditions were excluded. A checklist including items related to the research questions and overall quality of the articles was used for data collection and quality assessment. The reported prevalence rates were studied in relation to mean age, gender, study sample, year of publication, country of study, and quality score. To estimate the association between VESC and LBP, 2 × 2 tables were created to calculate the exact odds ratio (OR) with 95% confidence intervals. Eighty-two study samples from 77 original articles were identified and included in the analysis. The median of the reported prevalence rates for any type of VESC was 43% in patients with non-specific LBP and/or sciatica and 6% in non-clinical populations. The prevalence was positively associated with age and was negatively associated with the overall quality of the studies. A positive association between VESC and non-specific LBP was found in seven of ten studies from the general, working, and clinical populations with ORs from 2.0 to 19.9. This systematic review shows that VESC is a common MRI-finding in patients with non-specific LBP and is associated with pain. However, it should be noted that VESC may be present in individuals without LBP.
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Airaksinen O, Brox JI, Cedraschi C, Hildebrandt J et al (2006) Chapter 4. European guidelines for the management of chronic nonspecific low back pain. Eur Spine J 15(Suppl 2):S192–S300
Albert HB, Kjaer P, Jensen TS, Sorensen JS et al (2008) Modic changes, possible causes and relation to low back pain. Med Hypotheses 70:361–368. doi:10.1016/j.mehy.2007.05.014
Albert HB, Manniche C (2007) Modic changes following lumbar disc herniation. Eur Spine J 16:977–982. doi:10.1007/s00586-007-0336-8
An HS, Vaccaro AR, Dolinskas CA, Cotler JM et al (1991) Differentiation between spinal tumors and infections with magnetic resonance imaging. Spine 16:S334–S338. doi:10.1097/00007632-199110001-00019
Annunen S, Paassilta P, Lohiniva J, Perala M et al (1999) An allele of COL9A2 associated with intervertebral disc disease. Science 285:409–412. doi:10.1126/science.285.5426.409
Appel H, Loddenkemper C, Grozdanovic Z, Ebhardt H et al (2006) Correlation of histopathological findings and magnetic resonance imaging in the spine of patients with ankylosing spondylitis. Arthritis Res Ther 8:R143. doi:10.1186/ar2035
Asazuma T, Nobuta M, Sato M, Yamagishi M et al (2003) Lumbar disc herniation associated with separation of the posterior ring apophysis: analysis of five surgical cases and review of the literature. Acta Neurochir (Wien) 145:461–466
Assheuer J, Lenz G, Lenz W, Gottschlich KW et al (1987) Fat/water separation in the NMR tomogram. The imaging of bone marrow reactions in degenerative intervertebral disk changes. Rofo 147:58–63
Aunoble S, Hoste D, Donkersloot P, Liquois F et al (2006) Video-assisted ALIF with cage and anterior plate fixation for L5–S1 spondylolisthesis. J Spinal Disord Tech 19:471–476. doi:10.1097/01.bsd.0000211249.82823.d9
Baraliakos X, Brandt J, Listing J, Haibel H et al (2005) Outcome of patients with active ankylosing spondylitis after two years of therapy with etanercept: clinical and magnetic resonance imaging data. Arthritis Rheum 53:856–863. doi:10.1002/art.21588
Baraliakos X, Davis J, Tsuji W, Braun J (2005) Magnetic resonance imaging examinations of the spine in patients with ankylosing spondylitis before and after therapy with the tumor necrosis factor alpha receptor fusion protein etanercept. Arthritis Rheum 52:1216–1223. doi:10.1002/art.20977
Baraliakos X, Landewe R, Hermann KG, Listing J et al (2005) Inflammation in ankylosing spondylitis: a systematic description of the extent and frequency of acute spinal changes using magnetic resonance imaging. Ann Rheum Dis 64:730–734. doi:10.1136/ard.2004.029298
Baranto A, Hellstrom M, Nyman R, Lundin O et al (2006) Back pain and degenerative abnormalities in the spine of young elite divers: a 5-year follow-up magnetic resonance imaging study. Knee Surg Sports Traumatol Arthrosc 14:907–914. doi:10.1007/s00167-005-0032-3
Battie MC, Haynor DR, Fisher LD, Gill K et al (1995) Similarities in degenerative findings on magnetic resonance images of the lumbar spines of identical twins. J Bone Joint Surg Am 77:1662–1670
Battie MC, Videman T, Parent E (2004) Lumbar disc degeneration: epidemiology and genetic influences. Spine 29:2679–2690. doi:10.1097/01.brs.0000146457.83240.eb
Becker GT, Willburger RE, Liphofer J, Koester O et al (2006) Distribution of MRI signal alterations of the cartilage endplate in pre-operated patients with special focus on recurrent lumbar disc herniation. Rofo 178:46–54
Bennett DL, Nassar L, DeLano MC (2006) Lumbar spine MRI in the elite-level female gymnast with low back pain. Skeletal Radiol 35:503–509. doi:10.1007/s00256-006-0083-7
Braithwaite I, White J, Saifuddin A, Renton P 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. doi:10.1007/s005860050091
Bram J, Zanetti M, Min K, Hodler J (1998) MR abnormalities of the intervertebral disks and adjacent bone marrow as predictors of segmental instability of the lumbar spine. Acta Radiol 39:18–23
Braun J, Baraliakos X, Golder W, Brandt J et al (2003) Magnetic resonance imaging examinations of the spine in patients with ankylosing spondylitis, before and after successful therapy with infliximab: evaluation of a new scoring system. Arthritis Rheum 48:1126–1136. doi:10.1002/art.10883
Brown MF, Hukkanen MV, McCarthy ID, Redfern DR et al (1997) Sensory and sympathetic innervation of the vertebral endplate in patients with degenerative disc disease. J Bone Joint Surg Br 79:147–153. doi:10.1302/0301-620X.79B1.6814
Buttermann GR (2004) The effect of spinal steroid injections for degenerative disc disease. Spine J 4:495–505. doi:10.1016/j.spinee.2004.03.024
Buttermann GR, Heithoff KB, Ogilvie JW, Transfeldt EE et al (1997) Vertebral body MRI related to lumbar fusion results. Eur Spine J 6:115–120. doi:10.1007/BF01358743
Buttermann GR, Mullin WJ (2008) Pain and disability correlated with disc degeneration via magnetic resonance imaging in scoliosis patients. Eur Spine J 17:240–249. doi:10.1007/s00586-007-0530-8
Carragee E, Alamin T, Cheng I, Franklin T et al (2006) Are first-time episodes of serious LBP associated with new MRI findings? Spine J 6:624–635. doi:10.1016/j.spinee.2006.03.005
Carragee EJ, Alamin TF, Miller JL, Carragee JM (2005) Discographic, MRI and psychosocial determinants of low back pain disability and remission: a prospective study in subjects with benign persistent back pain. Spine J 5:24–35. doi:10.1016/j.spinee.2004.05.250
Carrino JA, Swathwood TC, Morrison WB, Glover JM (2007) Prospective evaluation of contrast-enhanced MR imaging after uncomplicated lumbar discography. Skeletal Radiol 36:293–299. doi:10.1007/s00256-006-0221-2
Castro WH, Halm H, Jerosch J, Steinbeck J et al (1994) Long-term changes in the magnetic resonance image after chemonucleolysis. Eur Spine J 3:222–224. doi:10.1007/BF02221597
Champsaur P, Parlier-Cuau C, Juhan V, Daumen-Legre V et al (2000) Differential diagnosis of infective spondylodiscitis and erosive degenerative disk disease. J Radiol 81:516–522
Chataigner H, Onimus M, Polette A (1998) Surgery for degenerative lumbar disc disease. Should the black disc be grafted? Rev Chir Orthop Reparatrice Appar 84:583–589
Chung CB, Vande Berg BC, Tavernier T, Cotten A et al (2004) End plate marrow changes in the asymptomatic lumbosacral spine: frequency, distribution and correlation with age and degenerative changes. Skeletal Radiol 33:399–404. doi:10.1007/s00256-004-0780-z
Collins CD, Stack JP, O’Connell DJ, Walsh M et al (1990) The role of discography in lumbar disc disease: a comparative study of magnetic resonance imaging and discography. Clin Radiol 42:252–257. doi:10.1016/S0009-9260(05)82113-0
Cvitanic OA, Schimandle J, Casper GD, Tirman PF (2000) Subchondral marrow changes after laser diskectomy in the lumbar spine: MR imaging findings and clinical correlation. AJR Am J Roentgenol 174:1363–1369
Dagirmanjian A, Schils J, McHenry M, Modic MT (1996) MR imaging of vertebral osteomyelitis revisited. AJR Am J Roentgenol 167:1539–1543
Danchaivijitr N, Temram S, Thepmongkhol K, Chiewvit P (2007) Diagnostic accuracy of MR imaging in tuberculous spondylitis. J Med Assoc Thai 90:1581–1589
Danielsson AJ, Cederlund CG, Ekholm S, Nachemson AL (2001) The prevalence of disc aging and back pain after fusion extending into the lower lumbar spine. A matched MR study twenty-five years after surgery for adolescent idiopathic scoliosis. Acta Radiol 42:187–197
de Roos A, Kressel H, Spritzer C, Dalinka M (1987) MR imaging of marrow changes adjacent to end plates in degenerative lumbar disk disease. AJR Am J Roentgenol 149:531–534
Elfering A, Semmer N, Birkhofer D, Zanetti M et al (2002) Risk factors for lumbar disc degeneration: a 5-year prospective MRI study in asymptomatic individuals. Spine 27:125–134. doi:10.1097/00007632-200201150-00002
Esposito P, Pinheiro-Franco JL, Froelich S, Maitrot D (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. doi:10.1016/S0028-3770(06)71225-5
Fagan A, Moore R, Vernon RB, Blumbergs P et al (2003) ISSLS prize winner: the innervation of the intervertebral disc: a quantitative analysis. Spine 28:2570–2576. doi:10.1097/01.BRS.0000096942.29660.B1
Fayad F, Lefevre-Colau MM, Rannou F, Quintero N et al (2007) Relation of inflammatory modic changes to intradiscal steroid injection outcome in chronic low back pain. Eur Spine J 16:925–931. doi:10.1007/s00586-006-0301-y
Flipo RM, Cotten A, Chastanet P, Ardaens Y et al (1996) Evaluation of destructive spondyloarthropathies in hemodialysis by computerized tomographic scan and magnetic resonance imaging. J Rheumatol 23:869–873
Freemont AJ, Peacock TE, Goupille P, Hoyland JA et al (1997) Nerve ingrowth into diseased intervertebral disc in chronic back pain. Lancet 350:178–181. doi:10.1016/S0140-6736(97)02135-1
Frobin W, Brinckmann P, Kramer M, Hartwig E (2001) Height of lumbar discs measured from radiographs compared with degeneration and height classified from MR images. Eur Radiol 11:263–269. doi:10.1007/s003300000556
Fruhwald F, Fruhwald S, Hajek PC, Schwaighofer B et al (1988) Focal fatty deposits in spinal bone marrow-MR findings. MRI of focal fatty deposits. Rofo 148:75–78
Gibson MJ, Buckley J, Mulholland RC, Worthington BS (1986) The changes in the intervertebral disc after chemonucleolysis demonstrated by magnetic resonance imaging. J Bone Joint Surg Br 68:719–723
Gillams AR, Chaddha B, Carter AP (1996) MR appearances of the temporal evolution and resolution of infectious spondylitis. AJR Am J Roentgenol 166:903–907
Gokhale YA, Ambardekar AG, Bhasin A, Patil M et al (2003) Brucella spondylitis and sacroiliitis in the general population in Mumbai. J Assoc Physicians India 51:659–666
Grand CM, Bank WO, Baleriaux D, Matos C et al (1993) Gadolinium enhancement of vertebral endplates following lumbar disc surgery. Neuroradiology 35:503–505. doi:10.1007/BF00588706
Grane P, Josephsson A, Seferlis A, Tullberg T (1998) Septic and aseptic post-operative discitis in the lumbar spine-evaluation by MR imaging. Acta Radiol 39:108–115
Gratz S, Dorner J, Fischer U, Behr TM et al (2002) 18F-FDG hybrid PET in patients with suspected spondylitis. Eur J Nucl Med Mol Imaging 29:516–524
Hajek PC, Baker LL, Goobar JE, Sartoris DJ et al (1987) Focal fat deposition in axial bone marrow: MR characteristics. Radiology 162:245–249
Hamanishi C, Kawabata T, Yosii T, Tanaka S (1994) Schmorl’s nodes on magnetic resonance imaging. Their incidence and clinical relevance. Spine 19:450–453. doi:10.1097/00007632-199402001-00012
Hancock MJ, Maher CG, Latimer J, Spindler MF et al (2007) Systematic review of tests to identify the disc, SIJ or facet joint as the source of low back pain. Eur Spine J 16:1539–1550. doi:10.1007/s00586-007-0391-1
Hayes CW, Jensen ME, Conway WF (1989) Non-neoplastic lesions of vertebral bodies: findings in magnetic resonance imaging. Radiographics 9:883–903
Herbsthofer B, Eysel P, Eckardt A, Humke T (1996) Diagnosis and therapy of erosive intervertebral osteochondrosis. Z Orthop Ihre Grenzgeb 134:465–471
Hermann KG, Bollow M (2004) Magnetic resonance imaging of the axial skeleton in rheumatoid disease. Best Pract Res Clin Rheumatol 18:881–907. doi:10.1016/j.berh.2004.06.005
Hirji KF, Tsiatis AA, Mehta CR (1989) Median unbiased estimation for binary data. Am Stat 43:7–11. doi:10.2307/2685158
Hosten N, Lemke AJ, Mayer HM, Dihlmann SW et al (1995) Spondylitis: borderline findings in magnetic resonance tomography. Aktuelle Radiol 5:164–168
Hung-ta HW, William BM, Schweitzer ME (2006) Edematous Schmorls nodes on thoracolumbar MR imaging: characteristic patterns and changes over time. Skeletal Radiol 35:212–219. doi:10.1007/s00256-005-0068-y
Ito M, Incorvaia KM, Yu SF, Fredrickson BE et al (1998) Predictive signs of discogenic lumbar pain on magnetic resonance imaging with discography correlation. Spine 23:1252–1258. doi:10.1097/00007632-199806010-00016
Jarvik JG, Hollingworth W, Heagerty PJ, Haynor DR et al (2005) Three-year incidence of low back pain in an initially asymptomatic cohort: clinical and imaging risk factors. Spine 30:1541–1548. doi:10.1097/01.brs.0000167536.60002.87
Jensen TS, Sorensen JS, Kjaer P (2007) Intra- and interobserver reproducibility of vertebral endplate signal (modic) changes in the lumbar spine: the Nordic Modic Consensus Group classification. Acta Radiol 48:748–754. doi:10.1080/02841850701422112
Jevtic V (2001) Magnetic resonance imaging appearances of different discovertebral lesions. Eur Radiol 11:1123–1135. doi:10.1007/s003300000727
Jevtic V, Kos-Golja M, Rozman B, McCall I (2000) Marginal erosive discovertebral “Romanus” lesions in ankylosing spondylitis demonstrated by contrast enhanced Gd-DTPA magnetic resonance imaging. Skeletal Radiol 29:27–33. doi:10.1007/s002560050005
Jevtic V, Majcen N (2004) Demonstration of evolution of hemispherical spondysclerosis by contrast enhanced Gd-DTPA magnetic resonance imaging. Radiol Oncol 38:275–284
Jim JJ, Noponen-Hietala N, Cheung KM, Ott J et al (2005) The TRP2 allele of COL9A2 is an age-dependent risk factor for the development and severity of intervertebral disc degeneration. Spine 30:2735–2742. doi:10.1097/01.brs.0000190828.85331.ef
Jones A, Clarke A, Freeman BJ, Lam KS et al (2005) The Modic classification: inter- and intraobserver error in clinical practice. Spine 30(16):1867–1869
Kahn T, Weigert F, Reiser M, Heuck A et al (1987) The MRT demonstration of bone marrow changes in intervertebral disk degeneration. Rofo 147:320–324
Kapeller P, Fazekas F, Krametter D, Koch M et al (1997) Pyogenic infectious spondylitis: clinical, laboratory and MRI features. Eur Neurol 38:94–98. doi:10.1159/000113167
Karacan IM, Aydin TM (2006) Lumbar disc herniation in ankylosing spondylitis: a dual role of discovertebral enthesopathy. Neurosurg Q 16:74–76. doi:10.1097/00013414-200606000-00004 Article
Karchevsky M, Schweitzer ME, Carrino JA, Zoga A et al (2005) Reactive endplate marrow changes: a systematic morphologic and epidemiologic evaluation. Skeletal Radiol 34:125–129. doi:10.1007/s00256-004-0886-3
Karppinen J, Daavittila I, Solovieva S, Kuisma M et al (2008) Genetic factors are associated with modic changes in endplates of lumbar vertebral bodies. Spine 33:1236–1241
Karppinen J, Mikkonen P, Kurunlahti M, Tervonen O et al (2003) Chronic Chlamydia pneumoniae infection increases the risk of occlusion of lumbar segmental arteries of patients with sciatica: a 3-year follow-up study. Spine 28:E284–E289. doi:10.1097/00007632-200308010-00022
Karppinen J, Paakko E, Paassilta P, Lohiniva J et al (2003) Radiologic phenotypes in lumbar MR imaging for a gene defect in the COL9A3 gene of type IX collagen. Radiology 227:143–148. doi:10.1148/radiol.2271011821
Karppinen J, Paakko E, Raina S, Tervonen O et al (2002) Magnetic resonance imaging findings in relation to the COL9A2 tryptophan allele among patients with sciatica. Spine 27:78–83. doi:10.1097/00007632-200201010-00018
Kato F, Ando T, Kawakami N, Mimatsu K et al (1993) The increased signal intensity at the vertebral body endplates after chemonucleolysis demonstrated by magnetic resonance imaging. Spine 18:2276–2281. doi:10.1097/00007632-199311000-00023
Kerttula LI, Serlo WS, Tervonen OA, Paakko EL et al (2000) Post-traumatic findings of the spine after earlier vertebral fracture in young patients: clinical and MRI study. Spine 25:1104–1108. doi:10.1097/00007632-200005010-00011
Kim JM, Lee SH, Ahn Y, Yoon DH et al (2007) Recurrence after successful percutaneous endoscopic lumbar discectomy. Minim Invasive Neurosurg 50:82–85. doi:10.1055/s-2007-982504
Kjaer P, Korsholm L, Bendix T, Sorensen JS et al (2006) Modic changes and their associations with clinical findings. Eur Spine J 15:1312–1319. doi:10.1007/s00586-006-0185-x
Kjaer P, Leboeuf-Yde C, Korsholm L, Sorensen JS 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. doi:10.1097/01.brs.0000162396.97739.76
Kjaer P, Leboeuf-Yde C, Sorensen JS, Bendix T (2005) An epidemiologic study of MRI and low back pain in 13-year-old children. Spine 30:798–806. doi:10.1097/01.brs.0000157424.72598.ec
Kleinstuck F, Dvorak J, Mannion AF (2006) Are “structural abnormalities” on magnetic resonance imaging a contraindication to the successful conservative treatment of chronic nonspecific low back pain? Spine 31:2250–2257. doi:10.1097/01.brs.0000232802.95773.89
Kokkonen SM, Kurunlahti M, Tervonen O, Ilkko E et al (2002) Endplate degeneration observed on magnetic resonance imaging of the lumbar spine: correlation with pain provocation and disc changes observed on computed tomography diskography. Spine 27:2274–2278. doi:10.1097/00007632-200210150-00017
Korhonen T, Karppinen J, Paimela L, Malmivaara A et al (2006) The treatment of disc herniation-induced sciatica with infliximab: one-year follow-up results of FIRST II, a randomized controlled trial. Spine 31:2759–2766. doi:10.1097/01.brs.0000245873.23876.1e
Kowalski TJ, Layton KF, Berbari EF, Steckelberg JM et al (2007) Follow-up MR imaging in patients with pyogenic spine infections: lack of correlation with clinical features. AJNR Am J Neuroradiol 28:693–699
Kuisma M, Karppinen J, Niinimaki J, Kurunlahti M et al (2006) A three-year follow-up of lumbar spine endplate (Modic) changes. Spine 31:1714–1718. doi:10.1097/01.brs.0000224167.18483.14
Kuisma M, Karppinen J, Niinimaki J, Ojala R et al (2007) Modic changes in endplates of lumbar vertebral bodies: prevalence and association with low back and sciatic pain among middle-aged male workers. Spine 32:1116–1122. doi:10.1097/01.brs.0000261561.12944.ff
Lang P, Chafetz N, Genant HK, Morris JM (1990) Lumbar spinal fusion. Assessment of functional stability with magnetic resonance imaging. Spine 15:581–588. doi:10.1097/00007632-199006000-00028
Langlois S, Cedoz JP, Lohse A, Toussirot E et al (2005) Aseptic discitis in patients with ankylosing spondylitis: a retrospective study of 14 cases. Joint Bone Spine 72:248–253. doi:10.1016/j.jbspin.2004.05.015
Langlois S, Cedoz JP, Lohse A, Toussirot E et al (2005) Les spondylodiscites aseptiques de la spondylarthrite ankylosante : etude retrospective de 14 cas. Rev Rhum 72:420–426. doi:10.1016/j.rhum.2004.05.022
Laredo JD, Vuillemin-Bodaghi V, Boutry N, Cotten A et al (2007) SAPHO syndrome: MR appearance of vertebral involvement. Radiology 242:825–831. doi:10.1148/radiol.2423051222
Ledermann HP, Schweitzer ME, Morrison WB, Carrino JA (2003) MR imaging findings in spinal infections: rules or myths? Radiology 228:506–514. doi:10.1148/radiol.2282020752
Lee SI, Jin W (1999) MR imaging of Schmorl’s nodes and several factors influencing enhancement of Schmorl’s nodes. Riv Neuroradiol 12:191–192
Lenz GP, Assheuer J, Lenz W, Gottschlich KW (1990) New aspects of lumbar disc disease. MR imaging and histological findings. Arch Orthop Trauma Surg 109:75–82. doi:10.1007/BF00439383
Lim CH, Jee WH, Son BC, Kim DH et al (2005) Discogenic lumbar pain: association with MR imaging and CT discography. Eur J Radiol 54:431–437. doi:10.1016/j.ejrad.2004.05.014
Liphofer JP, Theodoridis T, Becker GT, Koester O et al (2006) (Modic) signal alterations of vertebral endplates and their correlation to a minimally invasive treatment of lumbar disc herniation using epidural injections. Rofo 178:1105–1114
Liphofer JP, Theodoridis T, Becker GT, Koester O et al (2006) (Modic) signal alterations of vertebral endplates and their correlation to a minimally invasive treatment of lumbar disc herniation using epidural injections. Rofo 178:1105–1114
Lusins JO, Cicoria AD, Goldsmith SJ (1998) SPECT and lumbar MRI in back pain with emphasis on changes in end plates in association with disc degeneration. J Neuroimaging 8:78–82
Maksymowych WP, Dhillon SS, Park R, Salonen D et al (2007) Validation of the spondyloarthritis research consortium of Canada magnetic resonance imaging spinal inflammation index: is it necessary to score the entire spine? Arthritis Rheum 57:501–507. doi:10.1002/art.22627
Malinin T, Brown MD (2007) Changes in vertebral bodies adjacent to acutely narrowed intervertebral discs: observations in baboons. Spine 32:E603–E607
Marc V, Dromer C, Le Guennec P, Manelfe C et al (1997) Magnetic resonance imaging and axial involvement in spondylarthropathies. Delineation of the spinal entheses. Rev Rhum Engl Ed 64:465–473
Marzo-Ortega H, McGonagle D, O’Connor P, Emery P (2001) Efficacy of etanercept in the treatment of the entheseal pathology in resistant spondylarthropathy: a clinical and magnetic resonance imaging study. Arthritis Rheum 44:2112–2117. doi :10.1002/1529-0131(200109)44:9<2112::AID-ART363>3.0.CO;2-H
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. doi:10.1007/s00330-004-2314-4
Modic MT, Masaryk TJ, Ross JS, Carter JR (1988) Imaging of degenerative disk disease. Radiology 168:177–186
Modic MT, Steinberg PM, Ross JS, Masaryk TJ et al (1988) Degenerative disk disease: assessment of changes in vertebral body marrow with MR imaging. Radiology 166:193–199
Molla E, Marti-Bonmati L, Arana E, Martinez-Bisbal MC et al (2005) Magnetic resonance myelography evaluation of the lumbar spine end plates and intervertebral disks. Acta Radiol 46:83–88. doi:10.1080/02841850510016036
Moore RJ, Vernon-Roberts B, Osti OL, Fraser RD (1996) Remodeling of vertebral bone after outer anular injury in sheep. Spine 21:936–940. doi:10.1097/00007632-199604150-00006
Mulconrey DS, Knight RQ, Bramble JD, Paknikar S et al (2006) Interobserver reliability in the interpretation of diagnostic lumbar MRI and nuclear imaging. Spine J 6:177–184. doi:10.1016/j.spinee.2005.08.011
Narvani AA, Tsiridis E, Wilson LF (2003) High-intensity zone, intradiscal electrothermal therapy, and magnetic resonance imaging. J Spinal Disord Tech 16:130–136
Ohtori S, Inoue G, Ito T, Koshi 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. doi:10.1097/01.brs.0000215027.87102.7c
Paassilta P, Lohiniva J, Goring HH, Perala M et al (2001) Identification of a novel common genetic risk factor for lumbar disk disease. JAMA 285:1843–1849. doi:10.1001/jama.285.14.1843
Park SW, Lee JH, Ehara S, Park YB et al (2004) Single shot fast spin echo diffusion-weighted MR imaging of the spine; Is it useful in differentiating malignant metastatic tumor infiltration from benign fracture edema? Clin Imaging 28:102–108. doi:10.1016/S0899-7071(03)00247-X
Penta M, Sandhu A, Fraser RD (1995) Magnetic resonance imaging assessment of disc degeneration 10 years after anterior lumbar interbody fusion. Spine 20:743–747. doi:10.1097/00007632-199503150-00018
Peterson CK, Gatterman B, Carter JC, Humphreys BK et al (2007) Inter- and intraexaminer reliability in identifying and classifying degenerative marrow (Modic) changes on lumbar spine magnetic resonance scans. J Manipulative Physiol Ther 30:85–90. doi:10.1016/j.jmpt.2006.12.001
Putzier M, Schneider SV, Funk JF, Tohtz SW et al (2005) The surgical treatment of the lumbar disc prolapse: nucleotomy with additional transpedicular dynamic stabilization versus nucleotomy alone. Spine 30:E109–E114. doi:10.1097/01.brs.0000154630.79887.ef
Quack C, Schenk P, Laeubli T, Spillmann S et al (2007) Do MRI findings correlate with mobility tests? An explorative analysis of the test validity with regard to structure. Eur Spine J 16:803–812. doi:10.1007/s00586-006-0264-z
Raininko R, Manninen H, Battie MC, Gibbons LE et al (1995) Observer variability in the assessment of disc degeneration on magnetic resonance images of the lumbar and thoracic spine. Spine 20:1029–1035. doi:10.1097/00007632-199505000-00009
Rajasekaran S, Babu JN, Arun R, Armstrong BR et al (2004) ISSLS prize winner: a study of diffusion in human lumbar discs: a serial magnetic resonance imaging study documenting the influence of the endplate on diffusion in normal and degenerate discs. Spine 29:2654–2667. doi:10.1097/01.brs.0000148014.15210.64
Rannou F, Ouanes W, Boutron I, Lovisi B et al (2007) High-sensitivity C-reactive protein in chronic low back pain with vertebral end-plate Modic signal changes. Arthritis Rheum 57:1311–1315. doi:10.1002/art.22985
Raya JG, Dietrich O, Birkenmaier C, Sommer J et al (2007) Feasibility of a RARE-based sequence for quantitative diffusion-weighted MRI of the spine. Eur Radiol 17:2872–2879. doi:10.1007/s00330-007-0618-x
Ross JS, Zepp R, Modic MT (1996) The postoperative lumbar spine: enhanced MR evaluation of the intervertebral disk. AJNR Am J Neuroradiol 17:323–331
Saifuddin A, Renton P, Taylor BA (1998) Effects on the vertebral end-plate of uncomplicated lumbar discography: an MRI study. Eur Spine J 7:36–39. doi:10.1007/s005860050024
Sandhu HS, Sanchez-Caso LP, Parvataneni HK, Cammisa FP Jr et al (2000) Association between findings of provocative discography and vertebral endplate signal changes as seen on MRI. J Spinal Disord 13:438–443. doi:10.1097/00002517-200010000-00012
Saywell WR, Crock HV, England JP, Steiner RE (1989) Demonstration of vertebral body end plate veins by magnetic resonance imaging. Br J Radiol 62:290–292
Schenk P, Laubli T, Hodler J, Klipstein A (2006) Magnetic resonance imaging of the lumbar spine: findings in female subjects from administrative and nursing professions. Spine 31:2701–2706. doi:10.1097/01.brs.0000244570.36954.17
Schmid G, Witteler A, Willburger R, Kuhnen C et al (2004) Lumbar disk herniation: correlation of histologic findings with marrow signal intensity changes in vertebral endplates at MR imaging. Radiology 231:352–358. doi:10.1148/radiol.2312021708
Seki S, Kawaguchi Y, Mori M, Mio F et al (2006) Association study of COL9A2 with lumbar disc disease in the Japanese population. J Hum Genet 51:1063–1067. doi:10.1007/s10038-006-0062-9
Seymour R, Williams LA, Rees JI, Lyons K et al (1998) Magnetic resonance imaging of acute intraosseous disc herniation. Clin Radiol 53:363–368. doi:10.1016/S0009-9260(98)80010-X
Sharif HS, Aideyan OA, Clark DC, Madkour MM et al (1989) Brucellar and tuberculous spondylitis: comparative imaging features. Radiology 171:419–425
Shen M, Razi A, Lurie JD, Hanscom B et al (2007) Retrolisthesis and lumbar disc herniation: a preoperative assessment of patient function. Spine J 7:406–413. doi:10.1016/j.spinee.2006.08.011
Siddiqui AH, Rafique MZ, Ahmad MN, Usman MU (2005) Role of magnetic resonance imaging in lumbar spondylosis. J Coll Physicians Surg Pak 15:396–399
Song KS, Ogden JA, Ganey T, Guidera KJ (1997) Contiguous discitis and osteomyelitis in children. J Pediatr Orthop 17:470–477. doi:10.1097/00004694-199707000-00012 Infection
Stabler A, Baur A, Kruger A, Weiss M et al (1998) Differential diagnosis of erosive osteochondrosis and bacterial spondylitis: magnetic resonance tomography (MRT). Rofo 168:421–428
Stabler A, Bellan M, Weiss M, Gartner C et al (1997) MR imaging of enhancing intraosseous disk herniation (Schmorl’s nodes). AJR Am J Roentgenol 168:933–938
Stabler A, Weiss M, Scheidler J, Krodel A et al (1996) Degenerative disk vascularization on MRI: correlation with clinical and histopathologic findings. Skeletal Radiol 25:119–126. doi:10.1007/s002560050047
Stumpe KD, Zanetti M, Weishaupt D, Hodler J et al (2002) FDG positron emission tomography for differentiation of degenerative and infectious endplate abnormalities in the lumbar spine detected on MR imaging. AJR Am J Roentgenol 179:1151–1157
Takeno K, Kobayashi S, Yonezawa T, Hayakawa K et al (2006) Salvage operation for persistent low back pain and sciatica induced by percutaneous laser disc decompression performed at outside institution: correlation of magnetic resonance imaging and intraoperative and pathological findings. Photomed Laser Surg 24:414–423. doi:10.1089/pho.2006.24.414
Tanigawa N, Komemushi A, Kariya S, Kojima H et al (2006) Percutaneous vertebroplasty: relationship between vertebral body bone marrow edema pattern on MR images and initial clinical response. Radiology 239:195–200. doi:10.1148/radiol.2391050073
Toyone T, Takahashi K, Kitahara H, Yamagata M 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
Trout AT, Kallmes DF, Layton KF, Thielen KR et al (2006) Vertebral endplate fractures: an indicator of the abnormal forces generated in the spine after vertebroplasty. J Bone Miner Res 21:1797–1802. doi:10.1359/jbmr.060723
Tyrrell PN, Davies AM, Evans N, Jubb RW (1995) Signal changes in the intervertebral discs on MRI of the thoracolumbar spine in ankylosing spondylitis. Clin Radiol 50:377–383. doi:10.1016/S0009-9260(05)83134-4
Ulrich JA, Liebenberg EC, Thuillier DU, Lotz JC (2007) ISSLS prize winner: repeated disc injury causes persistent inflammation. Spine 32:2812–2819
Van Goethem JW, Parizel PM, Jinkins JR (2002) Review article: MRI of the postoperative lumbar spine. Neuroradiology 44:723–739. doi:10.1007/s00234-002-0790-2
Van Goethem JW, Parizel PM, van den Hauwe L, Van de Kelft E et al (2000) The value of MRI in the diagnosis of postoperative spondylodiscitis. Neuroradiology 42:580–585. doi:10.1007/s002340000361
Videman T, Battie MC, Ripatti S, Gill K et al (2006) Determinants of the progression in lumbar degeneration: a 5-year follow-up study of adult male monozygotic twins. Spine 31:671–678. doi:10.1097/01.brs.0000202558.86309.ea
Virtanen IM, Song YQ, Cheung KMC, Ala-Kokko L et al (2007) Phenotypic and population differences in the association between CILP and lumbar disc disease. J Med Genet 44:285–288. doi:10.1136/jmg.2006.047076
Visuri T, Pihlajamaki H, Eskelin M (2005) Long-term vertebral changes attributable to postoperative lumbar discitis: a retrospective study of six cases. Clin Orthop Relat Res (433) 97–105. doi:10.1097/01.blo.0000151425.00945.2a
Vital JM, Gille O, Pointillart V, Pedram M et al (2003) Course of Modic 1 six months after lumbar posterior osteosynthesis. Spine 28:715–720. doi:10.1097/00007632-200304010-00017
Voormolen MH, van Rooij WJ, Sluzewski M, van der Graaf Y et al (2006) Pain response in the first trimester after percutaneous vertebroplasty in patients with osteoporotic vertebral compression fractures with or without bone marrow edema. AJNR Am J Neuroradiol 27:1579–1585
Wagner AL, Murtagh FR, Arrington JA, Stallworth D (2000) Relationship of Schmorl’s nodes to vertebral body endplate fractures and acute endplate disk extrusions. AJNR Am J Neuroradiol 21:276–281
Wagner SC, Schweitzer ME, Morrison WB, Przybylski GJ et al (2000) Can imaging findings help differentiate spinal neuropathic arthropathy from disk space infection? Initial experience. Radiology 214:693–699
Weishaupt D, Zanetti M, Hodler J, Boos N (1998) MR imaging of the lumbar spine: prevalence of intervertebral disk extrusion and sequestration, nerve root compression, end plate abnormalities, and osteoarthritis of the facet joints in asymptomatic volunteers. Radiology 209:661–666
Weishaupt D, Zanetti M, Hodler J, Min K et al (2001) Painful lumbar disk derangement: relevance of endplate abnormalities at MR imaging. Radiology 218:420–427
Wienands K, Lukas P, Albrecht HJ (1990) Clinical value of MR tomography of spondylodiscitis in ankylosing spondylitis. Z Rheumatol 49:356–360
Yong PY, Alias NAA, Shuaib IL (2003) Correlation of clinical presentation, radiography, and magnetic resonance imaging for low back pain—a preliminary survey. J Hong Kong Coll Radiol 6:144–151
Yuh WT, Marsh EEIII, Wang AK, Russell JW et al (1992) MR imaging of spinal cord and vertebral body infarction. AJNR Am J Neuroradiol 13:145–154
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This study is supported by grants from the Danish Foundation of Chiropractic Research and Postgraduate Education (Tue Secher Jensen).
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Jensen, T.S., Karppinen, J., Sorensen, J.S. et al. Vertebral endplate signal changes (Modic change): a systematic literature review of prevalence and association with non-specific low back pain. Eur Spine J 17, 1407–1422 (2008). https://doi.org/10.1007/s00586-008-0770-2
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DOI: https://doi.org/10.1007/s00586-008-0770-2