The modic vertebral endplate and marrow changes: pathologic significance and relation to low back pain and segmental instability of the lumbar spine

Abstract

Two decades following their description, the significance of Modic vertebral endplate and marrow changes remains a matter of debate. These changes are closely related to the normal degenerative process affecting the lumbar spine, and their prevalence increases with age. However, the exact pathogenesis underlying these changes and their relation to segmental instability of the lumbar spine and to low back pain remain unclear. In this paper, we review the literature relevant to this topic and discuss the currently available evidence regarding the pathologic and clinical significance of Modic changes.

Figures

Fig 1.

Modic type 1 changes are hypointense on T1WI (A) and hyperintense on T2WI (B).

Fig 2.

Modic type 2 changes are hyperintense on T1WI (A) and isointense or hyperintense on T2WI (B).

Fig 3.

Modic type 3 changes are hypointense on both T1WI (A) and T2WI (B).