Top

European Spine Journal

Published in:

01-06-2012 | Original Article

Modic type I change may predict rapid progressive, deforming disc degeneration: a prospective 1-year follow-up study

Authors: Liisa Kerttula, Katariina Luoma, Tapio Vehmas, Mats Grönblad, Eeva Kääpä

Published in: European Spine Journal | Issue 6/2012

Abstract

Introduction

This prospective magnetic resonance imaging (MRI) study in chronic low-back pain (CLBP) patients evaluated the natural course of degenerative lumbar spine changes in relation to Modic 1 type changes (M1) within 1 year.

Materials and methods

From 3,811 consecutive CLBP patients referred to lumbar spine MRI 54 patients with a large M1 were selected using strict exclusion criteria to exclude specific back disorders. Follow-up MRI was obtained within 11–18 months.

Results

At baseline M1 was associated with an adjacent endplate lesion in 96% of the cases. In follow-up, an unstable M1 was associated both with an increase of endplate lesions, decrease of disc height and change in disc signal intensity, most found at L4/5 or L5/S1. In disc spaces without M1, progression of degenerative changes was rare.

Conclusion

Endplate deformation, decreasing disc height and change of disc signal intensity appear essential features of accelerated degenerative process associated with M1.

Braithwaite I, White J, Saifuddin A, Renton P, Taylor BA (1998) Vertebral end-plate (Modic) changes on lumbar spine MRI: correlation with pain reproduction at lumbar discography. Eur Spine J 7:363–368PubMedCrossRef

Weishaupt D, Zanetti M, Hodler J, Min K, Fuchs B, Pfirrmann CW, Boos N (2001) Painful lumbar disk derangement: relevance of endplate abnormalities at MR imaging. Radiology 218:420–427PubMed

Kuisma M, Karppinen J, Niinimäki J, Ojala R, Haapea M, Heliövaara M, Korpelainen R, Taimela S, Natri A, Tervonen O (2007) Modic changes in endplates of lumbar vertebral bodies. Prevalence and association with low back and sciatic pain among middle-aged male workers. Spine 32:1116–1122PubMedCrossRef

Weishaupt D, Zanetti M, Hodler J, Boos N (1998) MR imaging of the lumbar spine: prevalence of intervertebral disk extrusion and sequestration, nerve root compression, end plate abnormalities, and osteoarthritis of the facet joints in asymptomatic volunteers. Radiology 209:661–666PubMed

Modic MT, Steinberg PM, Ross JS, Masaryk TJ, Carter JR (1988) Degenerative disk disease: assessment of changes in vertebral body marrow with MR imaging. Radiology 166:193–199PubMed

Jensen TS, Kjaer P, Korsholm L, Bendix T, Sorensen JS, Manniche C, Leboeuf-Yde C (2010) Predictors of new vertebral endplate signal (Modic) changes in the general population. Eur Spine J 19:129–135PubMedCrossRef

Kuisma M, Karppinen J, Niinimäki J, Kurunlahti M, Haapea M, Vanharanta H, Tervonen O (2006) A three-year follow-up of lumbar spine endplate (Modic) changes. Spine 31:1714–1718PubMedCrossRef

Albert HB, Manniche C (2007) Modic changes following lumbar disc herniation. Eur Spine J 16:977–982PubMedCrossRef

Boos N, Weissbach S, Rohrbach H, Weiler C, Spratt KF, Nerlich AG (2002) Classification of age-related changes in lumbar intervertebral discs: 2002 Volvo Award in basic science. Spine 27:2631–2644PubMedCrossRef

10.

Mitra D, Cassar-Pullicino VN, McCall IW (2004) Longitudinal study of vertebral type-1 end-plate changes on MR of the lumbar spine. Eur Radiol 14:1574–1581PubMedCrossRef

11.

Luoma K, Vehmas T, Grönblad M, Kerttula L, Kääpä E (2008) MRI follow-up of subchondral signal abnormalities in a selected group of chronic low back pain patients. Eur Spine J 17:1300–1308PubMedCrossRef

12.

Luoma K, Vehmas T, Grönblad M, Kerttula L, Kääpä E (2009) Relationship of Modic type 1 change with disc degeneration: a prospective MRI study. Skeletal Radiol 38:237–244PubMedCrossRef

13.

Pfirrmann CW, Metzdorf A, Zanetti M, Hodler J, Boos N (2001) Magnetic resonance classification of lumbar intervertabral disc degeneration. Spine 26:1873–1878PubMedCrossRef

14.

Yu S, Haughton VM, Ho PS, Sether LA, Wagner M, Ho KC (1988) Progressive and regressive changes in the nucleus pulposus. Part II: the adult. Radiology 169:93–97PubMed

15.

Gönen M, Panageas KS, Larson SM (2001) Statistical issues in analysis of diagnostic imaging experiments with multiple observations per patient. Radiology 221:763–767PubMedCrossRef

16.

Killip S, Mahfoud Z, Pearce K (2004) What is an intracluster correlation coefficient? Crucial concepts for primary care researchers. Ann Fam Med 2:204–208PubMedCrossRef

17.

Adams MA, Freeman BJ, Morrison HP, Nelson IW, Dolan P (2000) Mechanical initiation of intervertebral disc degeneration. Spine 25:1625–1636PubMedCrossRef

18.

Moore RJ (2000) The vertebral end-plate: what do we know? Eur Spine J 9:92–96PubMedCrossRef

19.

Rajasekaran S, Babu JN, Arun R, Armstrong BR, Shetty AP, Murugan S (2004) A study of diffusion in human lumbar discs: a serial magnetic resonance imaging study documenting the influence of the endplate on diffusion in normal and degenerate discs. Spine 29:2654–2667PubMedCrossRef

20.

Modic MT, Masaryk TJ, Ross JS, Carter JR (1988) Imaging of degenerative disk disease. Radiology 168:177–186PubMed

21.

Jinkins JR (2004) Acquired degenerative changes of the intervertebral segments at and suprajacent to the lumbosacral junction. A radioanatomic analysis of the nondiscal structures of the spinal column and perispinal soft tissues. Eur J Radiol 50:134–158PubMedCrossRef

Title: Modic type I change may predict rapid progressive, deforming disc degeneration: a prospective 1-year follow-up study
Authors: Liisa Kerttula
Katariina Luoma
Tapio Vehmas
Mats Grönblad
Eeva Kääpä
Publication date: 01-06-2012
Publisher: Springer-Verlag
Published in: European Spine Journal / Issue 6/2012
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-012-2147-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Modic type I change may predict rapid progressive, deforming disc degeneration: a prospective 1-year follow-up study

Abstract

Introduction

Materials and methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Materials and methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 6/2012

Answer to the letter to the editor of Srijit Das et al. doi:10.1007/s00586-012-2165-7

Percutaneous multilevel reconstruction in revision surgery

Influence of transforaminal lumbar interbody fusion procedures on spinal and pelvic parameters of sagittal balance

Development of percutaneously insertable/removable interspinous process spacer for treatment of posture-dependent lumbar spinal-canal stenosis: preclinical feasibility study using porcine model

Pedicle subtraction osteotomy for postoperative flat back and sagittal imbalance

Congenital kypho-scoliosis: a case of thoracic insufficiency syndrome and the limitations of treatment