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Open Access 01-10-2019 | Discography | Review Article

Measuring and reporting of vertebral endplate bone marrow lesions as seen on MRI (Modic changes): recommendations from the ISSLS Degenerative Spinal Phenotypes Group

Authors: Aaron J. Fields, Michele C. Battié, Richard J. Herzog, Jeffrey G. Jarvik, Roland Krug, Thomas M. Link, Jeffrey C. Lotz, Conor W. O’Neill, Aseem Sharma, for the ISSLS Degenerative Spinal Phenotypes Group

Published in: European Spine Journal | Issue 10/2019

Abstract

Purpose

The positive association between low back pain and MRI evidence of vertebral endplate bone marrow lesions, often called Modic changes (MC), offers the exciting prospect of diagnosing a specific phenotype of chronic low back pain (LBP). However, imprecision in the reporting of MC has introduced substantial challenges, as variations in both imaging equipment and scanning parameters can impact conspicuity of MC. This review discusses key methodological factors that impact MC classification and recommends guidelines for more consistent MC reporting that will allow for better integration of research into this LBP phenotype.

Methods

Non-systematic literature review.

Results

The high diagnostic specificity of MC classification for a painful level contributes to the significant association observed between MC and LBP, whereas low and variable sensitivity underlies the between- and within-study variability in observed associations. Poor sensitivity may be owing to the presence of other pain generators, to the limited MRI resolution, and to the imperfect reliability of MC classification, which lowers diagnostic sensitivity and thus influences the association between MC and LBP. Importantly, magnetic field strength and pulse sequence parameters also impact detection of MC. Advances in pulse sequences may improve reliability and prove valuable for quantifying lesion severity.

Conclusions

Comparison of MC data between studies can be problematic. Various methodological factors impact detection and classification of MC, and the lack of reporting guidelines hinders interpretation and comparison of findings. Thus, it is critical to adopt imaging and reporting standards that codify acceptable methodological criteria.

Graphic abstract

These slides can be retrieved under Electronic Supplementary Material.

Available only for authorised users

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Title: Measuring and reporting of vertebral endplate bone marrow lesions as seen on MRI (Modic changes): recommendations from the ISSLS Degenerative Spinal Phenotypes Group
Authors: Aaron J. Fields
Michele C. Battié
Richard J. Herzog
Jeffrey G. Jarvik
Roland Krug
Thomas M. Link
Jeffrey C. Lotz
Conor W. O’Neill
Aseem Sharma
for the ISSLS Degenerative Spinal Phenotypes Group
Publication date: 01-10-2019
Publisher: Springer Berlin Heidelberg
Keywords: Discography
Back Pain
Back Pain
Back Pain
Published in: European Spine Journal / Issue 10/2019
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-019-06119-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Measuring and reporting of vertebral endplate bone marrow lesions as seen on MRI (Modic changes): recommendations from the ISSLS Degenerative Spinal Phenotypes Group

Abstract

Purpose

Methods

Results

Conclusions

Graphic abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Graphic abstract

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