Modic changes in lumbar spine: prevalence and distribution patterns of end plate oedema and end plate sclerosis

Abstract

Objective: The purpose of this study is to evaluate the distribution of end plate oedema in different types of Modic change especially in mixed type and to analyze the presence of end plate sclerosis in various types of Modic change. Materials and methods: 276 patients with low back pain were scanned with 1.5-T MRI. Three radiologists assessed the MR images by T 1 weighted, T 2 weighted and fat-saturation T 2 weighted sequences and classified them according to the Modic changes. Pure oedematous end plate signal changes were classified as Modic Type I; pure fatty end plate changes were classified as Modic Type II; and pure sclerotic end plate changes as Modic Type III. A mixed feature of both Types I and II with predominant oedematous signal change is classified as Modic I-II, and a mixture of Types I and II with predominant fatty change is classified as Modic II-I. Thus, the mixed types can further be subdivided into seven subtypes: Types I-II, Types II-I, Types I-III, Types III-I, Types II-III, Types III-II and Types I-III. During the same period, 52 of 276 patients who underwent CT and MRI were retrospectively reviewed to determine end plate sclerosis.

Vertebral Bone Marrow and Endplate Assessment on MR Imaging for the Differentiation of Modic Type 1 Endplate Changes and Infectious Spondylodiscitis

“…The latter may be explained by the reactive nature of edema, and, in addition, by overlapping Modic type 2 changes in 33.9% of MT1, which represented fatty marrow conversion that likely masked the expected T1-w signal decrease in edema. The additional Modic type 2 and 3 changes, most commonly seen in MT1 patients, also demonstrated the dynamic nature and possible mixed pattern of Modic changes [38].…”

Claw sign: MRI of degenerative disc disease

“…Pain is also associated with other phases. Sclerosis, as demonstrated on CT, can be present in all 3 types (not just type 3) …”

Low back pain and Modic changes

“…На микро-КТ выявляются изменения, связанные с повышением уровня образования костной ткани и снижением ее резорбции [11]. На изображе-ниях, полученных при проведении рентгенографии и мультиспиральной компьютерной томографии (МСКТ), этот тип характеризуется значительным уплотнением костной ткани -остеосклерозом [19,20].…”

“…Кроме трех описанных типов МСh, существуют смешанные подтипы: 1-2, 2-1, 1-3, 3-1, 2-3, 3-2 и 1-2-3, визуализирующиеся как сочетание изменений МР-сигнала, соответствующих отеку, жировому перерождению костного мозга и склерозу КПП. МР-признаки отека обнаруживаются в 92,7% от общего количества смешанных случаев МСh, особенно при типах 1-2 и 2-1 [19]. При проведении МСКТ смешанных подтипов МСh в 36,6% случаев обнаруживаются склеротические изменения в КПП [19].…”