Modic Changes Explained

In this blog post I will provide a brief summary of Modic changes, which are named after Dr Michael Modic who first described them 25 years ago.

Modic Changes are physical changes to the vertebra of the spine, which have been associated with lower back pain.

Both infection and mechanical causes have been shown to create Modic Changes, and recent research shows that antibiotic treatment has been effective in a significant percentage of patients.

There are three types of Modic Changes, which in simple terms we can describe with reference to their appearance on an MRI scan and the lower back pain that they have been associated with

Type 1 typically sees the formation of micro fractures in the thread of the vertebra, that contain fluid rather than healthy bone marrow. Research has shown that lower back pain is frequently felt in patients that also show signs of Modic Changes.

As Modic Changes progress to Type 2, that fluid forms in to yellow fat and is more visible on MRI scans. However, research of Type 2 cases shows less of a correlation with lower back pain relative to type 1 cases, although objectively speaking the correlation is still high.

Research has not shown a correlation between Modic Changes type 3 and lower back pain.

Most patients showing signs of Modic Changes have type 1 for several years, moving to type 2 and sometimes Modic Changes type 3.

For a more detailed explanation and for links to research in to Modic Changes, read my journal article here.

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