Introduction Erosive intervertebral osteochondritis is the destructive form of intervertebral osteochondrosis with inflammatory degeneration of the intervertebral disk. In Modic type I classification, there is an inflammation in vertebral plates and bone marrow, with MRI hypersignal in T2, STIR and T1 with Gadolinium sequences, and hyposignal in T1-weighted MRI; there is no change in the intensity of disk signal. The main difference of erosive intervertebral osteochondritis with Modic I changes is that there is a hypersignal in the disk itself in T2, STIR, and T1 with Gadolinium sequences, in addition to the characteristic changes of Modic I. The erosive intervertebral osteochondritis is rarely mentioned in the spine literature, and sometimes it is controversial because of its similarity with MRI imagenology of infectious disease. But there are clinical characteristics, imagenology, and blood test that help to analyze and make differential diagnosis with infectious diskitis. Modic has only one mention to the hyperintensity of disk with Gadolinium, probably due to fibrovascular granulation. Our aim is to analyze the clinical and radiological presentation of patients with lumbar and cervical erosive intervertebral osteochondritis, and to describe their treatment and outcomes. Materials and Methods A retrospective analysis of patients with lumbar and cervical erosive intervertebral osteochondritis. There were 28 patients, 14 female and 14 male. Average age was 44 years (range: 29 to 57). Mean follow-up was 27 months (range: 12 months to 8 years). A total of 23 cases affected lumbar spine and 5 cases affected cervical spine. The study consisted in static and dynamic X-ray of lumbar and cervical spine, CT scan, MRI enhanced with Gadolinium, diskitis serologic tests (sedimentation rate, white cell counting, CRP, procalcitonin), and psychological evaluation. No needle biopsy was performed in lumbar cases. In two cervical cases treated with fusion, the disk was send to biopsy and culture. All patients had only axial pain, with lumbar and cervical muscle contracture, rigidity, and limited mobility. No one had neurologic symptoms. The most characteristic clinical finding was severe pain in the back during sneeze and percussion. Treatment was conservative in 13 of the 23 lumbar cases. Surgical treatment was performed in 10 lumbar cases (8 female, 2 male): 4 open posterolateral pedicle screw fusion with autologous bone graft, 3 MISS posterolateral pedicle screw fusion witht bone substitute, and 3 percutaneous pedicle screws fixation and fusion with bone substitutes (Mozaic). The conservative treatment was based on restriction of activity and NSAID. Physiotherapy was needed for several weeks, especially in female patients. There was 10/14 (71.4%) female patients with associated fibromyalgia that were treated with psychotherapy and anxiolytic and antidepressant medication when needed. In cervical cases, three were treated conservatively and in two cases (both female) anterior cervical diskectomy and fusion with cage and pla...