A three-year follow-up of lumbar spine endplate (Modic) changes

Spine (Phila Pa 1976). 2006 Jul 1;31(15):1714-8. doi: 10.1097/01.brs.0000224167.18483.14.


Study design: A longitudinal follow-up of Modic changes on magnetic resonance imaging (MRI).

Objectives: To assess the prevalence and natural course Modic changes over a 3-year follow-up period.

Summary of background data: Modic changes are bone marrow and endplate lesions visible on MRI. To the authors' knowledge, no follow-up studies on their natural course have been published.

Methods: The study population consisted of 60 unoperated sciatica patients 23 to 76 years of age. Baseline and 3-year lumbar MR images from L1-L2 through L5-S1 were analyzed independently by 2 radiologists and a consensus reading was performed.

Results: At baseline, the prevalence of Modic changes was 23%. Seven discs had mixed Type I/II, and 63 Type II change. Changes typically occurred at L4-L5 and L5-S1, and associated positively with age (P = 0.009). Ten of 70 discs (14%) with Modic changes at baseline displayed another type at 3 years. Furthermore, the nonconverted changes increased significantly in size. The incidence of new Modic changes during the follow-up was 6% (13 of 230).

Conclusions: Modic changes are common MRI findings in patients with degenerative lumbar disc disease. We found evidence that Modic Type II changes may be less stable than previously assumed.

MeSH terms

  • Adult
  • Aged
  • Disease Progression
  • Female
  • Follow-Up Studies
  • Humans
  • Incidence
  • Intervertebral Disc / pathology
  • Intervertebral Disc Displacement / epidemiology*
  • Intervertebral Disc Displacement / pathology*
  • Lumbar Vertebrae / pathology*
  • Magnetic Resonance Imaging*
  • Male
  • Middle Aged
  • Prevalence
  • Prospective Studies
  • Sciatica / epidemiology*
  • Sciatica / pathology*