Modic types (vertebral endplates bone marrow changes)

With aging, reactive degenerative changes frequently occur in the vertebral endplates and vertebral bodies (Karchevsky et al. 2005).

In 1988, Modic and colleagues described three degenerative stages of vertebral endplates and subchondral bone (Modic et al. 1988a,b).

  • Type 1 changes (decreased signal intensity on T1-weighted images and increased signal intensity on T2-weighted images) indicate bone marrow edema associated with acute or subacute infl ammation. Histopathologically, Modic type 1 changes correspond to disruption and fi ssuring of the endplates and vascularized fi brous tissue with bone marrow edema. In patients with painful lumbar instability, Modic type 1 lesions are frequently found (Parizel et al. 1999). In a large majority of cases, Modic type 1 lesions naturally transform into type 2 lesions (Mitra et al. 2004). The transformation usually takes place over a time course of 1–2 years, and can relate to a change in patient’s symptoms.

  • Type 2 changes (increased signal intensity on T1-weighted images and isointense or increased signal intensity on T2-weighted images) indicate replacement of normal bone marrow by fat. The evolution of type 1 into type 2 lesions is accelerated after osteosynthesis, probably by correcting mechanical instability (Vital et al. 2003).

  • Type 3 changes (decreased signal intensity on both T1- and T2-weighted images) indicates reactive osteosclerosis. Overall, Modic type 2 changes (fatty pattern) are the most common, with Modic type 3 changes (sclerotic pattern) being rare (Karchevsky et al. 2005). Types 2 and 3 indicate chronic changes, and tend to remain stable over many years.

The authors of the article do not fully agree with the need for separate isolation "Type 3 changes".



The following diagnoses link to this page:
  • Modic N.T. I typ