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Updated: Aug 7, 2026
A Mouse Model of Lumbar Spine Instability
Published on: April 23, 2021
A three-year follow-up of lumbar spine endplate (Modic) changes
Mari Kuisma1, Jaro Karppinen, Jaakko Niinimäki
1Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland. mari.kuisma@fimnet.fi
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.
Insights
Modic changes, common MRI findings in degenerative disc disease, are often Type II lesions. These changes can be less stable over time than previously thought, with some converting types and increasing size over three years.
Area of Science:
- Radiology and Imaging
- Spine Imaging
- Degenerative Disc Disease
Background:
- Modic changes represent bone marrow and endplate lesions visualized via MRI.
- Previous research has not extensively documented the natural progression of these changes.
Purpose of the Study:
- To determine the prevalence of Modic changes.
- To evaluate the natural course of Modic changes over a three-year period.
Main Methods:
- A longitudinal study involving 60 sciatica patients (ages 23-76) without prior surgery.
- Baseline and 3-year lumbar MRI scans (L1-L2 to L5-S1) were analyzed by two independent radiologists with consensus review.
Main Results:
- The baseline prevalence of Modic changes was 23%, predominantly Type II at levels L4-L5 and L5-S1, correlating with older age.
- Over three years, 14% of baseline Modic changes converted to a different type, and non-converted changes significantly increased in size.
- New Modic changes developed in 6% of discs during the follow-up period.
Conclusions:
- Modic changes are frequent findings in patients with degenerative lumbar disc disease.
- Evidence suggests that Modic Type II changes exhibit greater instability than previously assumed.
