A definition and clinical grading of Modic changes

Abstract

To provide an up-to-date description of knowledge and pitfalls related to the classification, definition and grading of Modic changes (MC) visualized on magnetic resonance imaging (MRI). State-of-the-art review of current knowledge regarding the definition and grading of MC on MRI. MC on MRI have been reported to be associated with low back pain and disability. However, previous studies have shown heterogeneous results in regards to the impact of MC and its clinical relevance in patients with back pain. MC is a term used with considerable variation in the literature. No strict definition has been provided previously, this has contributed to varying diagnostic inclusion criteria, heterogeneous study populations, and discrepancy in results. A definition of MC and a proposal for grading is provided in this state-of-the-art review. MC are important, clinically relevant findings. However, issues with the nomenclature, definition and grading of these changes need to be addressed. Our current review highlights relevant issues related to MC, and provides a definition and grading score for the term MC that includes the Modic type and the extent of vertebral body involvement. Future studies should seek to validate the MC grading score in clinically relevant populations.

Lumbar endplate microfracture injury induces Modic-like changes, intervertebral disc degeneration and spinal cord sensitization – An In Vivo Rat Model

“…This EP injury model was characterized using imaging modalities and defined MC presence and severity using MRI [46] that provides parallels to the human clinical condition. MCs are vertebral endplate and adjacent bone marrow lesions visible via MRI, including three phenotypes (MCs type1, MCs type2, MCs type3), first described by de Roos et al [53] and Modic et al [10].…”

“…T1-weighted (T1w) images were acquired using 3D MP-RAGE (139 μm isotropic resolution, TR=4s, TI=1.1s), T2-weighted (T2w) images were acquired using 3D RARE (139 μm isotropic resolution, TR=2s, TE=17ms), and T2 mapping data were acquired using multi-echo 3D spin-echo (remmiRARE, 250 μm isotropic resolution, TR=520ms, TE1=6ms, ΔTE=5ms, 32 echoes). T1w and T2w images were analyzed for Modic changes using methods previously described [10, 46].…”

Red Light-Mediated Photoredox Catalysis Triggers Nitric Oxide Release for Treatment of Cutibacterium Acne Induced Intervertebral Disc Degeneration

“…Low back pain (LBP) is a common health issue with a high lifetime prevalence (∼80%), in which ∼10% of patients suffer from chronic low back pain (CLBP) that can lead to disability . Therefore, CLBP brings great challenges to personal health and social medical care, while intervertebral disc degeneration (IVDD) and Modic changes are recognized as an important cause of CLBP. , The incidence of IVDD can be attributed to genetics, trauma, stress, infection, etc., while Modic changes are closely associated with IVDD, which is manifested by abnormal signals of cartilage and bone end plates . Modic changes (MCs) are a type of bone marrow lesion of the vertebrae adjacent to degenerated discs.…”

“…Modic changes (MCs) are a type of bone marrow lesion of the vertebrae adjacent to degenerated discs. Three types of MCs have been defined based on their appearance on T1-weighted and T2-weighted magnetic resonance imaging (MRI). , Unfortunately, despite the high prevalence of IVDD, the clinically available tools for the treatment of IVDD are rather limited. Rest, physical therapy, and anti-inflammatory medication are the first line of conservative treatment.…”

“…3,4 The incidence of IVDD can be attributed to genetics, 5 trauma, 6 stress, 7 infection, 8 etc., while Modic changes are closely associated with IVDD, which is manifested by abnormal signals of cartilage and bone end plates. 9 Modic changes (MCs) are a type of bone marrow lesion of the vertebrae adjacent to degenerated discs. Three types of MCs have been defined based on their appearance on T1-weighted and T2-weighted magnetic resonance imaging (MRI).…”