Imaging of degenerative disk disease.

Modic, Michael T.; Masaryk, Thomas J.; Ross, Jeffrey S.; Carter, J R

doi:10.1148/radiology.168.1.3289089

Cited by 857 publications

(574 citation statements)

References 0 publications

Supporting

Mentioning

540

Contrasting

Unclassified

Order By: Relevance

“…MCs can only be visualized using Magnetic Resonance Imaging (MRI) and have been described as being a stage of the disc degeneration process [6]. Modic et al divided MCs into three types: Type I, II and III [7,8]. Histological studies show that Type I consists of fissured endplates and vascular granulation tissue adjacent to the endplate whereas Type II is characterized by a disruption of the endplates and fatty degeneration of the adjacent bone marrow [7].…”

Section: Introductionmentioning

confidence: 99%

“…Histological studies show that Type I consists of fissured endplates and vascular granulation tissue adjacent to the endplate whereas Type II is characterized by a disruption of the endplates and fatty degeneration of the adjacent bone marrow [7]. Type III seems to be similar to sclerosis of the bone marrow as seen on plain-film radiographs [8]. …”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Rest versus exercise as treatment for patients with low back pain and Modic changes. a randomized controlled clinical trial

Jensen

Leboeuf‐Yde

Wedderkopp

et al. 2012

BMC Med

View full text Add to dashboard Cite

BackgroundClinical experience suggests that many patients with Modic changes have relatively severe and persistent low back pain (LBP), which typically appears to be resistant to treatment. Exercise therapy is the recommended treatment for chronic LBP, however, due to their underlying pathology, Modic changes might be a diagnostic subgroup that does not benefit from exercise. The objective of this study was to compare the current state-of-the art treatment approach (exercise and staying active) with a new approach (load reduction and daily rest) for people with Modic changes using a randomized controlled trial design.MethodsParticipants were patients from an outpatient clinic with persistent LBP and Modic changes. They were allocated using minimization to either rest therapy for 10 weeks with a recommendation to rest for two hours daily and the option of using a flexible lumbar belt or exercise therapy once a week for 10 weeks. Follow-up was at 10 weeks after recruitment and 52 weeks after intervention and the clinical outcome measures were pain, disability, general health and global assessment, supplemented by weekly information on low back problems and sick leave measured by short text message (SMS) tracking.ResultsIn total, 100 patients were included in the study. Data on 87 patients at 10 weeks and 96 patients at one-year follow-up were available and were used in the intention-to-treat analysis. No statistically significant differences were found between the two intervention groups on any outcome.ConclusionsNo differences were found between the two treatment approaches, 'rest and reduced load' and 'exercise and staying active', in patients with persistent LBP and Modic changes.Trial RegistrationClinicalTrials.gov: NCT00454792

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Rest versus exercise as treatment for patients with low back pain and Modic changes. a randomized controlled clinical trial

Jensen

Leboeuf‐Yde

Wedderkopp

et al. 2012

BMC Med

View full text Add to dashboard Cite

show abstract

“…Depending on the changes in T1 and T2 MRI signals, three types of lesions were identified (Modic changes): Modic type 1 changes (low T1 and high T2 signal) were attributed to increased blood flow within the bone, type 2 changes (high T1 and T2 signals) possibly reflecting fatty degeneration of the bone marrow. Type 3 changes (low T1 and T2 signals) were assumed to correlate with subchondral bone sclerosis [1,2]. Their occurrence appears to increase with age and is associated with low back pain [3,4].…”

mentioning

confidence: 99%

“…Only a few papers have attempted to examine excised vertebral tissue specimens from patients with Modic changes [1][2][3]. In particular, to the best of the authors' knowledge, no quantitative comparison among the three Modic types, in micro-architectural and remodelling characteristics of the trabecular bone adjacent to the endplates, has yet been published.…”

mentioning

confidence: 99%

Modic (endplate) changes in the lumbar spine: bone micro-architecture and remodelling

et al. 2014

View full text Add to dashboard Cite

Purpose In the literature, inter-vertebral MRI signal intensity changes (Modic changes) were associated with corresponding histological observations on endplate biopsies. However, tissue-level studies were limited. No quantitative histomorphometric study on bone biopsies has yet been conducted for Modic changes. The aim of this study was to characterise the bone micro-architectural parameters and bone remodelling indices associated with Modic changes. Methods Forty patients suffering from disabling low back pain, undergoing elective spinal surgery, and exhibiting Modic changes on MRI (Modic 1, n = 9; Modic 2, n = 25; Modic 3, n = 6), had a transpedicular vertebral body biopsy taken of subchondral bone. Biopsies were first examined by micro-CT, for 3D morphometric analysis of bone volume fraction (BV/TV), trabecular thickness (Tb.Th), trabecular separation, trabecular number, and structure model index. Then, samples underwent histological analysis, for determination of bone remodelling indices: osteoid surface to bone surface ratio (OS/BS), eroded surface to bone surface (ES/BS) and osteoid surface to eroded surface ratio (OS/ES). Results Micro-CT analysis revealed significantly higher BV/TV (up to 70 % increase, p \ 0.01) and Tb.Th (up to ?57 %, p \ 0.01) in Modic 3 biopsies, compared to Modic 1 and 2. Histological analysis showed significantly lower OS/BS in Modic 2 biopsies (more than 28 % decrease, p \ 0.05) compared to 1 and 3. ES/BS progressively decreased from Modic 1 to 2 to 3, whereas OS/ES progressively increased with significantly higher values in Modic 3 (up to 159 % increase, p \ 0.05) than in Modic 1 and 2. Conclusions Significant differences were found in bone micro-architectural parameters and remodelling indices among Modic types. Modic 1 biopsies had evidence of highest bone turnover, possibly due to an inflammatory process; Modic 2 biopsies were consistent with a reduced bone formation/remodelling stage; Modic 3 biopsies suggested a more stable sclerotic phase, with significantly increased BV/TV and Tb.Th compared to Modic 1 and 2, linked to increased bone formation and reduced resorption.

show abstract

“…We, therefore, did not use a method of grading the severity of end-plate changes as described by Modic et al [19], which is known to increase the accuracy for identification of painful discs. As a result, the study does not allow suitable comparison of the diagnostic impact of plain MRI with the MRI discography.…”

Section: Discussionmentioning

confidence: 99%

Percutaneous discography: comparison of low-dose CT, fluoroscopy and MRI in the diagnosis of lumbar disc disruption

et al. 2005

View full text Add to dashboard Cite

Imaging of degenerative disk disease.

Cited by 857 publications

References 0 publications

Rest versus exercise as treatment for patients with low back pain and Modic changes. a randomized controlled clinical trial

Rest versus exercise as treatment for patients with low back pain and Modic changes. a randomized controlled clinical trial

Modic (endplate) changes in the lumbar spine: bone micro-architecture and remodelling

Percutaneous discography: comparison of low-dose CT, fluoroscopy and MRI in the diagnosis of lumbar disc disruption

Contact Info

Product

Resources

About