الفهرس 
• MRI anatomy of the spineOnly 14 pages are availabe for public view
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Abstract
Modic changes are bone marrow and endplate changes adjacent to degenerative lumbar intervertebral discs. Three different Modic types (I, II, and III) were initially described by Modic1.
Since then, mixed Modic lesions (I/II and II/III) have been identified, suggesting that all Modic changes can progress from one type to another and that they all present different stages of the same pathologic process. A prevalence of 22% to 50% of disc levels affected by Modic changes has been observed in patients with degenerative intervertebral disc disease1,2.
The association of Modic changes with clinical symptoms has been evaluated in several studies. Toyone et al found an association between Modic Type I change and low back pain 75.
Mitra et al found a positive trend between the evolution of Type I to Type II change and symptom improvement. These authors also think that Type I is painful, at least at
Summary
some stage of the process. The etiology of Type I change remains unclear. It has been suggested that repeated trauma to the intervertebral disc results in upregulation of inflammatory mediators in the nucleus pulposus. Diffusion of such toxic chemicals through the vertebral endplates could then result in a local inflammatory reaction resulting in low back pain66.
Vital et al suggested that Modic Type I changes appear to be a good indicator of satisfactory surgical outcome after arthrodesis. However, it is probably premature to assume that Modic changes are themselves indicative of need for a specific intervention67