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A definition and clinical grading of Modic changes

Peter M Udby1,2, Dino Samartzis3,4, Leah Y Carreon2

  • 1Spine Unit, Department of Orthopedic Surgery, Zealand University Hospital, Roskilde, Denmark.

Journal of Orthopaedic Research : Official Publication of the Orthopaedic Research Society
|December 15, 2021
PubMed

Insights

Modic changes (MC) on MRI are linked to back pain, but inconsistent definitions cause confusion. This review proposes a standardized definition and grading system for Modic changes to improve research consistency.

Area of Science:

  • Radiology
  • Orthopedics
  • Spinal Imaging

Background:

  • Modic changes (MC) on MRI are frequently observed in patients with low back pain.
  • Previous research shows inconsistent findings regarding the clinical significance of MC.
  • Variations in terminology and lack of a standardized definition for MC contribute to research discrepancies.

Purpose of the Study:

  • To present an updated overview of current knowledge on Modic changes (MC) on MRI.
  • To address the challenges in classification, definition, and grading of MC.
  • To propose a standardized definition and grading system for MC.

Main Methods:

  • State-of-the-art literature review.
  • Analysis of existing knowledge regarding MC definition and grading.
  • Development of a proposed MC definition and grading score.

Main Results:

  • Modic changes (MC) on MRI are associated with low back pain but lack consistent definitions.
  • A proposed definition and grading score for MC, incorporating Modic type and vertebral body involvement, is presented.
  • Standardization is crucial for consistent diagnostic criteria and research outcomes.

Conclusions:

  • Modic changes (MC) are clinically relevant findings on MRI.
  • Addressing nomenclature, definition, and grading issues is essential for accurate interpretation and research.
  • The proposed MC grading score requires validation in clinical populations.
Keywords:
Modic changesdisc degenerationendplate changeslow back painmagnetic resonance imaging

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