Pedicle Marrow Signal Hyperintensity on Short Tau Inversion Recovery- and T2-Weighted Images: Prevalence and Relationship to Clinical Symptoms

Borg, Bryson; Modic, Michael T.; Obuchowski, Nancy A.; Cheah, Grace

doi:10.3174/ajnr.a2588

Cited by 28 publications

(17 citation statements)

References 34 publications

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“…Indeed, we found 7 SCs that were localized on the facet joint and did not affect the adjacent pedicle. The age of the study subjects also may have played a role in the different findings; mean age in our study was 62.8 years, compared with approximately 50 years in the previous studies 4,5) . There were two main findings related to the localization of the SCs: that 75% (27/36 SCs) were found at neighboring spinal levels across the facet joint, and that 36% (13/36 SCs) had continuity with Modic type 1 changes of the vertebral endplate.…”

Section: Discussioncontrasting

confidence: 37%

“…In a previous study, the prevalence of SCs in MRIs of patients with low back pain was reported to be 1.8% (7/400), and 2 out of the 7 patients with SCs were <30 years of age, with no additional abnormal findings 5) . These differences in prevalence and age distribution could have resulted mainly from variations in the analysis method.…”

Section: Discussionmentioning

confidence: 99%

“…Modic type 1 change, a well-known radiological finding around the vertebral endplates and subchondral bone marrow that neighbor degenerated intervertebral discs of the lumbar spine, suggests inflammation and bone marrow edema related to low back pain [1][2][3] . The clinical significance of similar SCs of the posterior elements has not yet been elucidated, although a few reports in the literature describe the occurrence 4,5) . Such SCs identified in the pedicle of the lumbar spine in pediatric patients, particularly those with high athletic activity, have been reported as an initial sign of stress fracture of the pars interarticularis (spondylolysis) [6][7][8][9] .…”

Section: Introductionmentioning

confidence: 99%

“…Such SCs identified in the pedicle of the lumbar spine in pediatric patients, particularly those with high athletic activity, have been reported as an initial sign of stress fracture of the pars interarticularis (spondylolysis) [6][7][8][9] . According to past reports, SCs in adult patients are thought to be associated with degeneration of the lumbar intervertebral disc or facet joint 4,5) . However, to the best of our knowledge, no studies have described in detail the clinical significance of SCs of the posterior elements, including factors such as prevalence, age distribution, and spinal level.…”

Section: Introductionmentioning

confidence: 99%

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Signal intensity changes of the posterior elements of the lumbar spine in symptomatic adults

Sugiura

Sakai

Tezuka

et al. 2017

Spine Surg Relat Res

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Abstract:Introduction: Modic type 1 changes around the vertebral endplate of the lumbar spine are well known to indicate inflammation; however, the clinical significance of similar SCs of the posterior elements has not been elucidated.Methods: Six hundred ninety-eight MRIs of patients with complaints of low back/leg pain were retrospectively examined. Target SCs in this study were hypointensity on T1-WI and hyperintensity on T2-WI or short tau inversion recovery sequences showing the same signal patterns seen in Modic type 1 change of the lumbar posterior elements. We analyzed the (1) Prevalence, symptom, and age distribution of SCs, (2) Localization of SCs and their association with Modic type 1 changes, (3) Spinal level distribution of SCs, (4) Association between SCs and disc degeneration of the affected spinal level, and (5) Association between SCs and radiological changes (spondylolisthesis, scoliosis).Results: (1) Among 698 adult patients, 36 (16 men, 20 women) exhibited SCs (5.2%). No SCs were identified in patients age <40 years. (2) Of the 36 SCs, 9 (25%) were localized at a single spinal level, while 27 (75%) were found at neighboring spinal levels across the facet joint. Thirteen SCs (36.1%) had continuity with Modic type 1 changes around the vertebral endplate, while 23 (63.9%) were localized to the posterior elements. (3) SCs were frequently identified in the lower lumbar spine below the L4 level. (4) More than 80% of the SCs involved disc degeneration. (5) Spondylolisthesis was associated with 93% of SCs in double-level, and scoliosis was associated with SCs in unilateral side. Conclusion:The prevalence of SCs in symptomatic adults was 5.2%. On the basis of observed disc degeneration, 75% of SCs were considered to indicate inflammation or bone marrow edema around the facet joint.

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Section: Discussioncontrasting

confidence: 37%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Signal intensity changes of the posterior elements of the lumbar spine in symptomatic adults

Sugiura

Sakai

Tezuka

et al. 2017

Spine Surg Relat Res

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“…This case highlights the importance of STIR MRI and diagnostic facet injection. The diagnostic utility of STIR MRI is optimal for ankylosing spondylitis (13), pedicle fracture and degenerative facet joints (14), and spondylolysis (15,16). Fluid collection, which is an indicator of inflammatory events, and bone marrow lesions, which could be micro bleeding in the bone marrow, can be evaluated on STIR MRI (17).…”

Section: Discussionmentioning

confidence: 99%

Accurate diagnosis of chronic low back pain in a high-level college athlete: a case report

et al. 2017

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: A 21-year-old woman who was high-level college softball player presented with a 6-month history of low back pain that had been treated unsuccessfully by medication at local clinics. There was tenderness in the left paravertebral muscle at the lower lumbar level. X-ray and computed tomography revealed congenital scoliosis and an L6 hemivertebra. Short tau inversion recovery magnetic resonance imaging showed a fluid collection at the left L6-S1 facet joint. We performed a diagnostic facet injection, consisting of 1% % lidocaine and steroids, that was infiltrated into the left facet joint at L6-S1. Her persistent low back pain disappeared immediately after the facet block. We diagnosed left-sided facet arthritis at L6-S1. Due to her multiple congenital anomalies, excessive loading occurred at the facet joint. Therefore, we opted for conservative management, including mobilization of the thoracic spine and stretching of hamstrings and quadriceps. This case report underscores the importance of accurate diagnosis of low back pain and of the diagnostic utility of short tau inversion recovery magnetic resonance imaging and lumbar facet block in young athletes with chronic spinal pain.

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A definition and clinical grading of Modic changes

Udby

Samartzis

Carreon

et al. 2021

Journal Orthopaedic Research

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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.

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Pedicle Marrow Signal Hyperintensity on Short Tau Inversion Recovery- and T2-Weighted Images: Prevalence and Relationship to Clinical Symptoms

Cited by 28 publications

References 34 publications

Signal intensity changes of the posterior elements of the lumbar spine in symptomatic adults

Signal intensity changes of the posterior elements of the lumbar spine in symptomatic adults

Accurate diagnosis of chronic low back pain in a high-level college athlete: a case report

A definition and clinical grading of Modic changes

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