The Natural History of Modic Changes - a 5- and 15-year Follow-up Study
Abstract
Modic changes (MCs), defined as bone marrow lesions adjacent to the vertebral endplate seen on MRI, have been associated with back pain. There are different types of MCs, with different histopathological correlates. This community-based study sample comprised 110 men from the Twin Spine Study, with baseline, 5-year, and 15-year follow-up MRIs. Following training and reliability testing, 1320 endplates (T12-S1) were evaluated for MC presence, type, and dimensions at each time point. Results demonstrated that Type 2 Modic Changes (MC2) were the most common type, with approximately half located at the two lowest disc levels. However, Type 1 Modic Changes (MC1) were distributed similarly across the lumbar region. Results suggest that MC1 is a transient phase, with no MC1s at baseline persisting to 15-year follow-up, and most converting to MC2. New MCs mostly occurred in the anterior aspect of the endplate, which may provide clues related to pathogenesis.