138:
invades the endplate and vertebral bone through fractures in the endplates and causes an inflammatory response. It may be nucleus material entering the vertebrae, but Crock et al. also suggested that after a disc is damaged, irritating substances are produced, draining into the vertebral body, and causing an autoimmune reaction. This mechanical theory is supported by the fact that histological findings of the Modic
Changes demonstrate disruption of the endplates with evidence of chronic inflammation. This in turn suggests that this erosion weakens the bone matrix, giving rise to stress fractures and consequent oedema. The universal reaction of bone under stress is seen in fractures wherever they occur and is always associated with pain.
129:
presence of bacteria vary significantly from very primitive methods such as simple culturing to highly sophisticated methods, where independent research groups utilizing staining techniques with fluorescence in situ hybridization were able to visualize bacteria from an ongoing infection as well as associated inflammatory cells. These studies were carried out in real time and therefore demonstrated an ongoing bacterial infection. The results of these studies have been reproduced in several systematic reviews, concluding that 30-34 % of patients with a disc herniation have bacteria in the extruded disc material.
237:
Modic changes. Since then, in total, 10 studies have been conducted evaluating the effect of antibiotic treatment in patients with chronic low back pain and Modic changes. Two clinically controlled studies with long-term follow-up and one clinically controlled study with short-term follow-up have been performed. In addition, seven cohort studies have been completed, of which there are follow-up results in the six of the studies.
1534:
Jaspaul S.; Gokaslan, Ziya L.; Kuo, Calvin C.; Lee, Yu-Po; Mavrommatis, Konstantinos; Michu, Elleni; Noskova, Hana; Raz, Assaf; Sana, Jiri; Shamie, A. Nick; Stewart, Philip S.; Stonemetz, Jerry L.; Wang, Jeffrey C.; Witham, Timothy F.; Coscia, Michael F.; Birkenmaier, Christof; Fischetti, Vincent A.; Slaby, Ondrej (3 April 2017).
120:
The bacterial cause is where the development of Modic change is due to an infection in the adjacent disc. A tear in the outer fibers of a disc may well initiate this infection. A disc herniation will result in a new local capillarization around the extruded material as the body attempts to remove the
57:
Modic changes is a descriptive term used by radiologists in MRI evaluations. Conventional treatment including physiotherapy, chiropractic, acupuncture, and exercise for back pain, are not effective in treating Modic changes. Conversely, long term antibiotic treatment has been shown to be an effective
2616:
Russo, Vittorio M.; Dhawan, Ranju T.; Dharmarajah, Nishanth; Baudracco, Irene; Lazzarino, Antonio I.; Casey, Adrian T. (August 2017). "Hybrid Bone Single Photon
Emission Computed Tomography Imaging in Evaluation of Chronic Low Back Pain: Correlation with Modic Changes and Degenerative Disc Disease".
146:
Modic changes have been observed in approximately 6% of the general adult population regardless of ethnicity. Modic changes are rare in children and young adults. From the age of 25 to 40 years, there is a steep increase in their prevalence, which levels out about 40 years of age and is stable until
124:
The anaerobic bacteria can enter the disc through the breach, causing a low virulent and slowly developing infection. Since the disc is an avascular structure, it is an ideal environment for the growth of anaerobic bacteria. Propionibacterium acnes bacteria secrete propionic acid, which can dissolve
53:
Modic changes have been observed in approximately 6% of the general adult population regardless of ethnicity. Modic changes are rare in children and young adults. From the age of 25 to 40 years, there is a steep increase in their prevalence, which levels out about 40 years of age and is stable until
2244:
Ohtori, Seiji; Inoue, Gen; Ito, Toshinori; Koshi, Takana; Ozawa, Tomoyuki; Doya, Hideo; Saito, Tomoko; Moriya, Hideshige; Takahashi, Kazuhisa (April 2006). "Tumor
Necrosis Factor-Immunoreactive Cells and PGP 9.5-Immunoreactive Nerve Fibers in Vertebral Endplates of Patients With Discogenic Low Back
2200:
Ohtori, Seiji; Inoue, Gen; Ito, Toshinori; Koshi, Takana; Ozawa, Tomoyuki; Doya, Hideo; Saito, Tomoko; Moriya, Hideshige; Takahashi, Kazuhisa (April 2006). "Tumor
Necrosis Factor-Immunoreactive Cells and PGP 9.5-Immunoreactive Nerve Fibers in Vertebral Endplates of Patients With Discogenic Low Back
1533:
Capoor, Manu N.; Ruzicka, Filip; Schmitz, Jonathan E.; James, Garth A.; Machackova, Tana; Jancalek, Radim; Smrcka, Martin; Lipina, Radim; Ahmed, Fahad S.; Alamin, Todd F.; Anand, Neel; Baird, John C.; Bhatia, Nitin; Demir-Deviren, Sibel; Eastlack, Robert K.; Fisher, Steve; Garfin, Steven R.; Gogia,
240:
Differences in the efficacy of antibiotics in treating Modic changes with antibiotics warrants further investigation of optimal treatment protocol with antibiotics and diagnosis. Treatment is generally not offered to individuals with modic changes in the healthcare system due to the lengthy process
232:
In the case that body tissue is infected with bacteria, this will, in most cases, lead to the patient being given treatment with antibiotics, which in most cases will cure the infection. A research group led by
Gilligan has presented a description of how they hypothesize 4 stages, from infection of
2572:
Kuisma, Mari; Karppinen, Jaro; Niinimäki, Jaakko; Ojala, Risto; Haapea, Marianne; Heliövaara, Markku; Korpelainen, Raija; Taimela, Simo; Natri, Antero; Tervonen, Osmo (May 2007). "Modic
Changes in Endplates of Lumbar Vertebral Bodies: Prevalence and Association With Low Back and Sciatic Pain Among
2479:
Kuisma, Mari; Karppinen, Jaro; Niinimäki, Jaakko; Ojala, Risto; Haapea, Marianne; Heliövaara, Markku; Korpelainen, Raija; Taimela, Simo; Natri, Antero; Tervonen, Osmo (May 2007). "Modic
Changes in Endplates of Lumbar Vertebral Bodies: Prevalence and Association With Low Back and Sciatic Pain Among
2386:
Kuisma, Mari; Karppinen, Jaro; Niinimäki, Jaakko; Ojala, Risto; Haapea, Marianne; Heliövaara, Markku; Korpelainen, Raija; Taimela, Simo; Natri, Antero; Tervonen, Osmo (May 2007). "Modic
Changes in Endplates of Lumbar Vertebral Bodies: Prevalence and Association With Low Back and Sciatic Pain Among
137:
Mechanical Modic changes might initially reflect bleeding, oedema, and vascularization following trauma or oedema associated with the repair process after micro-fractures within the endplate and the vertebral bone. Another possibility is that the toxic nucleus tissue (from the center of the discs)
128:
The first study by
Stirling and Lambert found Propionibacterium acnes in the extruded disc material in patients undergoing surgery inspired the bacterial theory. The discovery has led to many studies trying to identify bacteria in the disc material. The methods used in the studies to determine the
109:
Modic changes are a non-specific pathoanatomical marker observed on an MRI scan. For example, high blood pressure or high body temperature can be markers of several diseases. In 2008 the first hypothesis suggesting three possible pathogenetic reasons for Modic changes was published, a bacterial, a
3085:
Bråten, Lars
Christian Haugli; Rolfsen, Mads Peder; Espeland, Ansgar; Wigemyr, Monica; Aßmus, Jörg; Froholdt, Anne; Haugen, Anne Julsrud; Marchand, Gunn Hege; Kristoffersen, Per Martin; Lutro, Olav; Randen, Sigrun; Wilhelmsen, Maja; Winsvold, Bendik Slagsvold; Kadar, Thomas Istvan; Holmgard, Thor
219:
The most commonly recommended treatment for long-lasting pain in the lower back are exercises and fitness training usually under the supervision of a qualified clinician. This treatment does help the vast majority of back pain patients but does not have a pain-relieving effect on Modic changes or
155:
The natural development of Modic changes was observed in an extensive study of almost 800 English twins. These twins had an initial MRI diagnosing them with Modic changes and another MRI 10 years later. No treatment was given, thus only observing the development of Modic changes. The study showed
236:
The first study to investigate the efficacy of long-term antibiotic treatment for patients with Modic changes was published in 2013. This clinically randomized controlled trial showed this treatment to be a highly efficacious treatment for this subgroup of patients with chronic low back pain and
74:
The last decade of studies on Modic changes have shown that Modic changes are associated with many treatment-resistant pain episodes and may result in patients entering a state of chronic low back pain. On average, individuals with Modic changes have had chronic pain for longer than individuals
194:
Modic changes Type 2 contains high levels of fat associated with degeneration of the bone marrow, microfractures of the trabeculae, disruption of the endplates, and immunoreactive nerve fibers and TNF alpha cells. A mix of Type 1 and Type 2 have frequently been observed in the exact Modic
3086:
Einar; Vigeland, Maria Dehli; Vetti, Nils; Nygaard, Øystein Petter; Lie, Benedicte Alexandra; Hellum, Christian; Anke, Audny; Grotle, Margreth; Schistad, Elina Iordanova; Skouen, Jan Sture; Grøvle, Lars; Brox, Jens Ivar; Zwart, John-Anker; Storheim, Kjersti (16 October 2019).
202:
The proof of an ongoing pathologic process in a Modic change has been documented by SPECT analysis , combined with high-resolution CT imaging. This method has shown high metabolic activity in 96.1% of endplates with Modic change type I and 56% with Modic change type 2.
121:
extruded material and inflammation with macrophages which are present in abundance. The mucous membrane of the gums is slightly damaged during ordinary tooth brushing, and anaerobic bacteria Propionibacterium acnes type 2 from the mouth enters the bloodstream.
2803:
Saukkonen, Jesperi; Määttä, Juhani; Oura, Petteri; Kyllönen, Eero; Tervonen, Osmo; Niinimäki, Jaakko; Auvinen, Juha; Karppinen, Jaro (1 October 2020). "Association Between Modic Changes and Low Back Pain in Middle Age: A Northern Finland Birth Cohort Study".
223:
Modic changes are also an independent predictive marker for poor clinical outcomes, meaning that conventional treatments such as strength training, manipulations, physiotherapy, and surgery do not reduce the pain of individuals with Modic changes.
1246:
Ito, Takui; Yamada, Mitsunori; Ikuta, Fusahiro; Fukuda, Takeaki; Hoshi, Shin-ichi; Kawaji, Youichi; Uchiyama, Seiji; Homma, Takao; Takahashi, Hideaki E. (January 1996). "Histologic Evidence of Absorption of Sequestration-Type Herniated Disc".
2847:
Määttä, Juhani H.; Wadge, Sam; MacGregor, Alex; Karppinen, Jaro; Williams, Frances M.K. (August 2015). "ISSLS Prize Winner: Vertebral Endplate (Modic) Change is an Independent Risk Factor for Episodes of Severe and Disabling Low Back Pain".
100:
Individuals with Modic changes experience exacerbation of pain when performing a hyperextension of the back. A hyperextension of the back is the equivalent of performing an excessive backward bending of the back beyond its natural position.
2086:
Määttä, Juhani H.; Kraatari, Minna; Wolber, Lisa; Niinimäki, Jaakko; Wadge, Sam; Karppinen, Jaro; Williams, Frances M. K. (September 2014). "Vertebral endplate change as a feature of intervertebral disc degeneration: a heritability study".
1333:
Grönblad, Mats; Virri, Johanna; Tolonen, Jukka; Seitsalo, Seppo; Kääpä, Eeva; Kankare, Jyrki; Myllynen, Pertti; Karaharju, Erkki O. (December 1994). "A Controlled Immunohistochemical Study of Inflammatory Cells in Disc Herniation Tissue".
2892:
3332:
Gupta, G; Jarzem, P; Meredith, S; Radhakrishna, M; Besemann, M; Elgueta, MF; Charghi, R; Chankowsky, J (October 2017). "Antibiotics in the treatment of patients with lower back pain associated with Modic changes: a case series".
91:
Many individuals suffering from Modic changes, tend to have a high degree of morning stiffness in the back. The duration of the stiffness in the morning also tends to be longer compared to individuals with no Modic changes.
191:
Modic changes Type 1 reflects oedema adjacent to the disc, fissured endplates, microfractures of the trabeculae, granular tissue, high levels of immunoreactive nerve fibers, and TNF alpha cells (pro-inflammatory)
1691:
Ganko, Renata; Rao, Prashanth J.; Phan, Kevin; Mobbs, Ralph J. (May 2015). "Can Bacterial Infection by Low Virulent Organisms Be a Plausible Cause for Symptomatic Disc Degeneration? A Systematic Review".
1203:
Hirabayashi, S; Kumano, K; Tsuiki, T; Eguchi, M; Ikeda, S (November 1990). "A Dorsally Displaced Free Fragment of Lumbar Disc Herniation and Its Interesting Histologic Findings: A Case Report".
1377:
Bhanji, S; Williams, B; Sheller, B; Elwood, T; Mancl, L (July 2002). "Transient bacteremia induced by toothbrushing a comparison of the Sonicare toothbrush with a conventional toothbrush".
156:
that only 3.5% of the people who had Modic changes initially demonstrated that they had disappeared after ten years. Unfortunately, most of the Modic changes do not resolve spontaneously.
50:. Clinically, Modic Changes are often associated with constant lower back pain during the day, with peak pain occurring during the night and in the morning, coupled with back stiffness.
1595:"Bacterial biofilms: a possible mechanism for chronic infection in patients with lumbar disc herniation - a prospective proof-of-concept study using fluorescence in situ hybridization"
1866:
Kuisma, Mari; Karppinen, Jaro; Niinimäki, Jaakko; Ojala, Risto; Haapea, Marianne; Heliövaara, Markku; Korpelainen, Raija; Taimela, Simo; Natri, Antero; Tervonen, Osmo (May 2007).
556:
Kuisma, Mari; Karppinen, Jaro; Niinimäki, Jaakko; Ojala, Risto; Haapea, Marianne; Heliövaara, Markku; Korpelainen, Raija; Taimela, Simo; Natri, Antero; Tervonen, Osmo (May 2007).
3248:
Palazzo, C; Ferrari, M; Lefevre-Colau, MM; Nguyen, C; Rannou, F; Poiraudeau, S (July 2017). "Lack of effectiveness of antibiotics in chronic low back pain with Modic 1 changes".
3135:
Kristoffersen, Per Martin; Bråten, Lars C. H.; Vetti, Nils; Grøvle, Lars; Hellum, Christian; Storheim, Kjersti; Zwart, John-Anker; Assmus, Jörg; Espeland, Ansgar (1 June 2021).
3038:"Antibiotic treatment in patients with chronic low back pain and vertebral bone edema (Modic type 1 changes): a double-blind randomized clinical controlled trial of efficacy"
2989:"Antibiotic treatment in patients with chronic low back pain and vertebral bone edema (Modic type 1 changes): a double-blind randomized clinical controlled trial of efficacy"
2165:
Modic, M T; Steinberg, P M; Ross, J S; Masaryk, T J; Carter, J R (January 1988). "Degenerative disk disease: assessment of changes in vertebral body marrow with MR imaging".
2130:
Modic, M T; Steinberg, P M; Ross, J S; Masaryk, T J; Carter, J R (January 1988). "Degenerative disk disease: assessment of changes in vertebral body marrow with MR imaging".
359:"Efficacy of antibiotic treatment in patients with chronic low back pain and Modic changes (the AIM study): double blind, randomised, placebocontrolled, multicentre trial.""
3088:"Efficacy of antibiotic treatment in patients with chronic low back pain and Modic changes (the AIM study): double blind, randomised, placebo controlled, multicentre trial"
125:
fatty bone marrow and bone. Therefore, it was hypothesized that diffusion of propionic acid from the disc into the vertebrae results in bone oedema, i.e. Modic changes.
2687:
1290:
Doita, Minoru; Kanatani, Takako; Harada, Toshihiko; Mizuno, Kosaku (January 1996). "Immunohistologic Study of the Ruptured Intervertebral Disc of the Lumbar Spine".
1640:
Urquhart, Donna M; Zheng, Yiliang; Cheng, Allen C; Rosenfeld, Jeffrey V; Chan, Patrick; Liew, Susan; Hussain, Sultana Monira; Cicuttini, Flavia M (December 2015).
1490:
Stirling, Alistair; Worthington, Tony; Rafiq, Mohammed; Lambert, Peter A; Elliott, Tom SJ (June 2001). "Association between sciatica and Propionibacterium acnes".
3186:"Antibiotic Treatment in Patients with Chronic Low Back Pain and Vertebral Bone Edema (Modic Type I Changes): A Randomized Clinical Controlled Trial of Efficacy"
1829:"Modic changes of the lumbar spine: prevalence, risk factors, and association with disc degeneration and low back pain in a large-scale population-based cohort"
519:"Modic changes of the lumbar spine: prevalence, risk factors, and association with disc degeneration and low back pain in a large-scale population-based cohort"
2525:"The Modic Vertebral Endplate and Marrow Changes: Pathologic Significance and Relation to Low Back Pain and Segmental Instability of the Lumbar Spine"
2432:"The Modic Vertebral Endplate and Marrow Changes: Pathologic Significance and Relation to Low Back Pain and Segmental Instability of the Lumbar Spine"
2339:"The Modic Vertebral Endplate and Marrow Changes: Pathologic Significance and Relation to Low Back Pain and Segmental Instability of the Lumbar Spine"
3137:"Oedema on STIR modified the effect of amoxicillin as treatment for chronic low back pain with Modic changes—subgroup analysis of a randomized trial"
1072:"Inflammatory pain pattern and pain with lumbar extension associated with Modic 1 changes on MRI: a prospective case–control study of 120 patients"
974:"Inflammatory pain pattern and pain with lumbar extension associated with Modic 1 changes on MRI: a prospective case–control study of 120 patients"
876:"Inflammatory pain pattern and pain with lumbar extension associated with Modic 1 changes on MRI: a prospective case–control study of 120 patients"
778:"Inflammatory pain pattern and pain with lumbar extension associated with Modic 1 changes on MRI: a prospective case–control study of 120 patients"
251:
Modic MT, Steinberg PM, Ross JS, et al. (1988). "Degenerative disk disease: assessment of changes in vertebral body marrow with MR imaging".
1868:"Modic Changes in Endplates of Lumbar Vertebral Bodies: Prevalence and Association With Low Back and Sciatic Pain Among Middle-Aged Male Workers"
558:"Modic Changes in Endplates of Lumbar Vertebral Bodies: Prevalence and Association With Low Back and Sciatic Pain Among Middle-Aged Male Workers"
1915:"Vertebral endplate signal changes (Modic change): a systematic literature review of prevalence and association with non-specific low back pain"
605:"Vertebral endplate signal changes (Modic change): a systematic literature review of prevalence and association with non-specific low back pain"
421:"Vertebral endplate signal changes (Modic change): a systematic literature review of prevalence and association with non-specific low back pain"
111:
2893:"Endplate Defect Is Heritable, Associated With Low Back Pain and Triggers Intervertebral Disc Degeneration: A Longitudinal Study From TwinsUK"
172:
was the first to classify, describe and define Modic changes into three types. The different types were first described and defined in 1988.
2013:"The prevalence of MRI-defined spinal pathoanatomies and their association with Modic changes in individuals seeking care for low back pain"
703:"The prevalence of MRI-defined spinal pathoanatomies and their association with Modic changes in individuals seeking care for low back pain"
1121:"Association Between Inflammatory Back Pain Characteristics and Magnetic Resonance Imaging Findings in the Spine and Sacroiliac Joints"
1023:"Association Between Inflammatory Back Pain Characteristics and Magnetic Resonance Imaging Findings in the Spine and Sacroiliac Joints"
925:"Association Between Inflammatory Back Pain Characteristics and Magnetic Resonance Imaging Findings in the Spine and Sacroiliac Joints"
827:"Association Between Inflammatory Back Pain Characteristics and Magnetic Resonance Imaging Findings in the Spine and Sacroiliac Joints"
470:"Association Between Inflammatory Back Pain Characteristics and Magnetic Resonance Imaging Findings in the Spine and Sacroiliac Joints"
2652:
Gendron, Doherr, Gavin; et al. (2012). "Magnetic Resonance Imaging Characterization of Vertebral Endplate Changes in the Dog".
1593:
Ohrt-Nissen, Søren; Fritz, Blaine G.; Walbom, Jonas; Kragh, Kasper N.; Bjarnsholt, Thomas; Dahl, Benny; Manniche, Claus (May 2018).
1404:
Roberts, G. J.; Holzel, H. S.; Sury, M. R. J.; Simmons, N. A.; Gardner, P.; Longhurst, P. (1997). "Dental Bacteremia in Children".
2891:
Munir, Sabrina; Freidin, Maxim B.; Rade, Marinko; Määttä, Juhani; Livshits, Gregory; Williams, Frances M.K. (1 November 2018).
1827:
Mok, Florence P.S.; Samartzis, Dino; Karppinen, Jaro; Fong, Daniel Y.T.; Luk, Keith D.K.; Cheung, Kenneth M.C. (January 2016).
517:
Mok, Florence P.S.; Samartzis, Dino; Karppinen, Jaro; Fong, Daniel Y.T.; Luk, Keith D.K.; Cheung, Kenneth M.C. (January 2016).
3362:
2754:"Rest versus exercise as treatment for patients with low back pain and Modic changes. a randomized controlled clinical trial"
2703:"Rest versus exercise as treatment for patients with low back pain and Modic changes. a randomized controlled clinical trial"
1594:
1120:
1022:
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826:
469:
2011:
Albert, Hanne B.; Briggs, Andrew M.; Kent, Peter; Byrhagen, Andreas; Hansen, Christian; Kjaergaard, Karina (August 2011).
701:
Albert, Hanne B.; Briggs, Andrew M.; Kent, Peter; Byrhagen, Andreas; Hansen, Christian; Kjaergaard, Karina (August 2011).
2938:
Gilligan, Christopher J.; Cohen, Steven P.; Fischetti, Vincent A.; Hirsch, Joshua A.; Czaplewski, Lloyd G. (June 2021).
83:
Peak pain tends to occur late at night and in the morning. Late-night pain often results in poor and interrupted sleep.
3285:"Antibiotic treatment in patients with low-back pain associated with Modic changes Type 1 (bone oedema): a pilot study"
3209:"Vertebral Endplate Changes / Modic Changes: An Audit Study Using Antibiotics in 147 Chronic Low Back Pain Patients"
66:
Several studies have shown a relationship between Modic changes in the spinal vertebrae and pain in the lower back.
2290:"Vertebral end-plate (Modic) changes on lumbar spine MRI: correlation with pain reproduction at lumbar discography"
1913:
Jensen, Tue Secher; Karppinen, Jaro; Sorensen, Joan S.; Niinimäki, Jaakko; Leboeuf-Yde, Charlotte (November 2008).
1735:
Gilligan, Christopher J.; Cohen, Steven P.; Fischetti, Vincent A.; Hirsch, Joshua A.; Czaplewski, Lloyd G. (2021).
603:
Jensen, Tue Secher; Karppinen, Jaro; Sorensen, Joan S.; Niinimäki, Jaakko; Leboeuf-Yde, Charlotte (November 2008).
419:
Jensen, Tue Secher; Karppinen, Jaro; Sorensen, Joan S.; Niinimäki, Jaakko; Leboeuf-Yde, Charlotte (November 2008).
165:
2752:
Jensen, Rikke K; Leboeuf-Yde, Charlotte; Wedderkopp, Niels; Sorensen, Joan S; Manniche, Claus (December 2012).
2701:
Jensen, Rikke K; Leboeuf-Yde, Charlotte; Wedderkopp, Niels; Sorensen, Joan S; Manniche, Claus (December 2012).
147:
80+ years. Modic changes are estimated to affect approximately 349 million of the adult population worldwide.
54:
80+ years. Modic changes are estimated to affect approximately 349 million of the adult population worldwide.
2060:
750:
1536:"Propionibacterium acnes biofilm is present in intervertebral discs of patients undergoing microdiscectomy"
1070:
Bailly, F.; Maigne, J.-Y.; Genevay, S.; Marty, M.; Gandjbakhch, F.; Rozenberg, S.; Foltz, V. (March 2014).
972:
Bailly, F.; Maigne, J.-Y.; Genevay, S.; Marty, M.; Gandjbakhch, F.; Rozenberg, S.; Foltz, V. (March 2014).
874:
Bailly, F.; Maigne, J.-Y.; Genevay, S.; Marty, M.; Gandjbakhch, F.; Rozenberg, S.; Foltz, V. (March 2014).
776:
Bailly, F.; Maigne, J.-Y.; Genevay, S.; Marty, M.; Gandjbakhch, F.; Rozenberg, S.; Foltz, V. (March 2014).
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between new scientific knowledge and its acceptance and optimal application in the healthcare system.
1962:
Kjaer, Per; Korsholm, Lars; Bendix, Tom; Sorensen, Joan S.; Leboeuf-Yde, Charlotte (September 2006).
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Kjaer, Per; Korsholm, Lars; Bendix, Tom; Sorensen, Joan S.; Leboeuf-Yde, Charlotte (September 2006).
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Crock, HV (July 1986). "Internal disc disruption. A challenge to disc prolapse fifty years on".
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Crock, HV (July 1986). "Internal disc disruption. A challenge to disc prolapse fifty years on".
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Albert, Hanne B.; Sorensen, Joan S.; Christensen, Berit Schiott; Manniche, Claus (April 2013).
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Albert, Hanne B.; Sorensen, Joan S.; Christensen, Berit Schiott; Manniche, Claus (April 2013).
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Modic MT, Masaryk TJ, Ross JS, Carter JR (1988). "Imaging of degenerative disk disease".
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Braithwaite, I.; White, J.; Saifuddin, A.; Renton, P.; Taylor, B. A. (19 October 1998).
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1642:"Could low grade bacterial infection contribute to low back pain? A systematic review"
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2833:
2665:
1797:
1770:
1460:
1347:
1303:
1260:
1216:
1181:
215:
Exercise and surgery alone are ineffective treatments for patients with Modic changes
168:) scans. Bone oedema in other bones is not categorized into different types, but Dr.
3234:
2924:
2877:
2602:
2509:
2416:
2274:
2230:
2178:
2143:
1899:
1813:
1721:
1626:
1519:
1476:
1363:
1319:
1276:
1232:
1154:
1056:
958:
860:
589:
503:
293:
264:
2116:
1433:
23:
3318:
3261:
2956:
2939:
2908:
2861:
2817:
1844:
1753:
1736:
1705:
1560:
534:
1119:
Arnbak, Bodil; Jurik, Anne G.; Jensen, Tue S.; Manniche, Claus (February 2018).
1021:
Arnbak, Bodil; Jurik, Anne G.; Jensen, Tue S.; Manniche, Claus (February 2018).
923:
Arnbak, Bodil; Jurik, Anne G.; Jensen, Tue S.; Manniche, Claus (February 2018).
825:
Arnbak, Bodil; Jurik, Anne G.; Jensen, Tue S.; Manniche, Claus (February 2018).
468:
Arnbak, Bodil; Jurik, Anne G.; Jensen, Tue S.; Manniche, Claus (February 2018).
3152:
2630:
3053:
3004:
2100:
2028:
1979:
1930:
1658:
1168:
LINDBLOM, K; HULTQVIST, G (July 1950). "Absorption of protruded disc tissue".
1087:
989:
891:
793:
718:
669:
620:
436:
326:
184:
176:
3301:
3284:
2770:
2719:
1867:
1828:
557:
518:
43:
35:
3342:
3310:
3269:
3225:
3208:
3170:
3121:
3071:
3022:
2965:
2940:"Chronic low back pain, bacterial infection and treatment with antibiotics"
2916:
2869:
2825:
2789:
2738:
2673:
2638:
2594:
2558:
2501:
2465:
2408:
2372:
2266:
2222:
2108:
2046:
1997:
1948:
1891:
1852:
1762:
1737:"Chronic low back pain, bacterial infection and treatment with antibiotics"
1713:
1677:
1618:
1579:
1511:
1390:
1189:
1146:
1105:
1048:
1007:
950:
909:
852:
811:
736:
687:
638:
581:
542:
495:
454:
392:
344:
3185:
3184:
Al-Falahi, Mohanned A.; Salal, Mohammed H.; Abdul-Wahab, Dhiaa M. (2014).
2323:
2305:
2186:
2151:
1805:
1468:
1425:
1417:
1355:
1311:
1268:
1224:
301:
272:
2540:
2447:
2354:
399:
198:
Modic Change type 3 is rare and suggests a more stable sclerotic phase.
3103:
1610:
1137:
1039:
941:
843:
486:
374:
3283:
Albert, HB; Manniche, C; Sorensen, JS; Deleuran, BW (December 2008).
27:
352:
https://ama.com.au/ausmed/back-pain-breakthrough-crippled-doubt
1964:"Modic changes and their associations with clinical findings"
654:"Modic changes and their associations with clinical findings"
3207:
Manniche, Claus; Morsø, Lars; Kiertzner, Lene (April 2016).
233:
the discus to developing Modic changes in the vertebrae.
1170:
The Journal of Bone and Joint Surgery. American Volume
187:, is located in the hollows between the trabeculae.
311:"Modic changes following lumbar disc herniation.""
175:Normal bone contains internal scaffolding, called
2245:Pain and Modic Type 1 or Type 2 Changes on MRI".
2201:Pain and Modic Type 1 or Type 2 Changes on MRI".
8:
2686:: CS1 maint: multiple names: authors list (
75:suffering from non-Modic changes back pain.
3219:(1_suppl): s–0036–1582898-s-0036-1582898.
2067:. Central Intelligence Agency. 26 May 2022
757:. Central Intelligence Agency. 26 May 2022
206:Modic changes have been observed in dogs.
3300:
3224:
3160:
3111:
3061:
3012:
2955:
2779:
2769:
2728:
2718:
2548:
2455:
2362:
2313:
2036:
1987:
1938:
1752:
1667:
1657:
1569:
1559:
1136:
1095:
1038:
997:
940:
899:
842:
801:
726:
677:
628:
485:
444:
382:
334:
38:. These changes are situated in both the
110:mechanical, and a rheumatological cause.
411:
2679:
2654:Veterinary Radiology & Ultrasound
16:Pathological changes in the vertebrae
7:
3335:U.S. Army Medical Department Journal
400:http://dx.doi.org/10.1136/bmj.l5654
164:Modic changes are observed on MRI (
3289:British Journal of Sports Medicine
3190:Iraqi Postgraduate Medical Journal
2587:10.1097/01.brs.0000261561.12944.ff
2529:American Journal of Neuroradiology
2523:Rahme, R.; Moussa, R. (May 2008).
2494:10.1097/01.brs.0000261561.12944.ff
2436:American Journal of Neuroradiology
2430:Rahme, R.; Moussa, R. (May 2008).
2401:10.1097/01.brs.0000261561.12944.ff
2343:American Journal of Neuroradiology
2337:Rahme, R.; Moussa, R. (May 2008).
2259:10.1097/01.brs.0000215027.87102.7c
2215:10.1097/01.brs.0000215027.87102.7c
1884:10.1097/01.brs.0000261561.12944.ff
574:10.1097/01.brs.0000261561.12944.ff
14:
2666:10.1111/j.1740-8261.2011.01861.x
1798:10.1097/00007632-198607000-00028
1461:10.1097/00007632-198607000-00028
1348:10.1097/00007632-199412150-00002
1304:10.1097/00007632-199601150-00015
1261:10.1097/00007632-199601150-00014
1217:10.1097/00007632-199011010-00026
1182:10.2106/00004623-195032030-00009
2179:10.1148/radiology.166.1.3336678
2144:10.1148/radiology.166.1.3336678
294:10.1148/radiology.168.1.3289089
265:10.1148/radiology.166.1.3336678
96:Pain with lumbar hyperextension
58:treatment if done effectively.
151:Modic changes do not disappear
1:
1504:10.1016/S0140-6736(00)05109-6
1125:Arthritis Care & Research
1027:Arthritis Care & Research
929:Arthritis Care & Research
831:Arthritis Care & Research
474:Arthritis Care & Research
3262:10.1016/j.jbspin.2016.08.001
2957:10.1016/j.spinee.2021.02.013
2909:10.1097/BRS.0000000000002721
2862:10.1097/BRS.0000000000000937
2818:10.1097/BRS.0000000000003529
1845:10.1016/j.spinee.2015.09.060
1754:10.1016/j.spinee.2021.02.013
1706:10.1097/BRS.0000000000000832
1561:10.1371/journal.pone.0174518
535:10.1016/j.spinee.2015.09.060
2573:Middle-Aged Male Workers".
2480:Middle-Aged Male Workers".
2387:Middle-Aged Male Workers".
3379:
3153:10.1007/s00330-020-07542-w
2631:10.1016/j.wneu.2017.03.107
228:Treatment with antibiotics
166:magnetic resonance imaging
87:Morning pain and stiffness
3054:10.1007/s00586-013-2675-y
3005:10.1007/s00586-013-2675-y
2101:10.1007/s00586-014-3333-8
2029:10.1007/s00586-011-1794-6
1980:10.1007/s00586-006-0185-x
1931:10.1007/s00586-008-0770-2
1659:10.1186/s12916-015-0267-x
1088:10.1007/s00586-013-3036-6
990:10.1007/s00586-013-3036-6
892:10.1007/s00586-013-3036-6
794:10.1007/s00586-013-3036-6
719:10.1007/s00586-011-1794-6
670:10.1007/s00586-006-0185-x
621:10.1007/s00586-008-0770-2
437:10.1007/s00586-008-0770-2
327:10.1007/s00586-007-0336-8
220:pain from Modic changes.
3302:10.1136/bjsm.2008.050369
160:Diagnosing Modic changes
2771:10.1186/1741-7015-10-22
2720:10.1186/1741-7015-10-22
357:Bråten LCH (Aug 2019).
3226:10.1055/s-0036-1582898
3042:European Spine Journal
2993:European Spine Journal
2294:European Spine Journal
2089:European Spine Journal
2017:European Spine Journal
1968:European Spine Journal
1919:European Spine Journal
1076:European Spine Journal
978:European Spine Journal
880:European Spine Journal
782:European Spine Journal
707:European Spine Journal
658:European Spine Journal
609:European Spine Journal
425:European Spine Journal
309:Albert HB (Jul 2007).
70:Long term chronic pain
3363:Spinal cord disorders
2306:10.1007/s005860050091
1418:10.1007/s002469900103
105:Causes and Prevalence
40:body of the vertebrae
3213:Global Spine Journal
1406:Pediatric Cardiology
1552:2017PLoSO..1274518C
1498:(9273): 2024–2025.
1379:Pediatric Dentistry
116:Bacteria as a cause
46:of the neighboring
3141:European Radiology
2619:World Neurosurgery
2541:10.3174/ajnr.A0925
2448:10.3174/ajnr.A0925
2355:10.3174/ajnr.A0925
2065:The World Factbook
755:The World Factbook
62:Signs and Symptoms
3104:10.1136/bmj.l5654
2944:The Spine Journal
2903:(21): 1496–1501.
2856:(15): 1187–1193.
2812:(19): 1360–1367.
2581:(10): 1116–1122.
2488:(10): 1116–1122.
2395:(10): 1116–1122.
1925:(11): 1407–1422.
1878:(10): 1116–1122.
1833:The Spine Journal
1741:The Spine Journal
1700:(10): E587–E592.
1611:10.1111/apm.12841
1342:(24): 2744–2751.
1211:(11): 1231–1233.
1138:10.1002/acr.23259
1040:10.1002/acr.23259
942:10.1002/acr.23259
844:10.1002/acr.23259
615:(11): 1407–1422.
568:(10): 1116–1122.
523:The Spine Journal
487:10.1002/acr.23259
431:(11): 1407–1422.
375:10.1136/bmj.l5654
183:, which produces
3370:
3347:
3346:
3329:
3323:
3322:
3304:
3280:
3274:
3273:
3250:Joint Bone Spine
3245:
3239:
3238:
3228:
3204:
3198:
3197:
3181:
3175:
3174:
3164:
3147:(6): 4285–4297.
3132:
3126:
3125:
3115:
3082:
3076:
3075:
3065:
3033:
3027:
3026:
3016:
2984:
2978:
2977:
2959:
2935:
2929:
2928:
2888:
2882:
2881:
2844:
2838:
2837:
2800:
2794:
2793:
2783:
2773:
2749:
2743:
2742:
2732:
2722:
2698:
2692:
2691:
2685:
2677:
2649:
2643:
2642:
2613:
2607:
2606:
2569:
2563:
2562:
2552:
2520:
2514:
2513:
2476:
2470:
2469:
2459:
2427:
2421:
2420:
2383:
2377:
2376:
2366:
2334:
2328:
2327:
2317:
2285:
2279:
2278:
2253:(9): 1026–1031.
2241:
2235:
2234:
2209:(9): 1026–1031.
2197:
2191:
2190:
2162:
2156:
2155:
2127:
2121:
2120:
2095:(9): 1856–1862.
2083:
2077:
2076:
2074:
2072:
2057:
2051:
2050:
2040:
2023:(8): 1355–1362.
2008:
2002:
2001:
1991:
1974:(9): 1312–1319.
1959:
1953:
1952:
1942:
1910:
1904:
1903:
1863:
1857:
1856:
1824:
1818:
1817:
1781:
1775:
1774:
1756:
1732:
1726:
1725:
1688:
1682:
1681:
1671:
1661:
1637:
1631:
1630:
1590:
1584:
1583:
1573:
1563:
1530:
1524:
1523:
1487:
1481:
1480:
1444:
1438:
1437:
1401:
1395:
1394:
1374:
1368:
1367:
1330:
1324:
1323:
1287:
1281:
1280:
1243:
1237:
1236:
1200:
1194:
1193:
1165:
1159:
1158:
1140:
1116:
1110:
1109:
1099:
1067:
1061:
1060:
1042:
1018:
1012:
1011:
1001:
969:
963:
962:
944:
920:
914:
913:
903:
871:
865:
864:
846:
822:
816:
815:
805:
773:
767:
766:
764:
762:
747:
741:
740:
730:
713:(8): 1355–1362.
698:
692:
691:
681:
664:(9): 1312–1319.
649:
643:
642:
632:
600:
594:
593:
553:
547:
546:
514:
508:
507:
489:
465:
459:
458:
448:
416:
396:
386:
348:
338:
305:
276:
3378:
3377:
3373:
3372:
3371:
3369:
3368:
3367:
3353:
3352:
3351:
3350:
3331:
3330:
3326:
3282:
3281:
3277:
3247:
3246:
3242:
3206:
3205:
3201:
3183:
3182:
3178:
3134:
3133:
3129:
3084:
3083:
3079:
3035:
3034:
3030:
2986:
2985:
2981:
2937:
2936:
2932:
2890:
2889:
2885:
2846:
2845:
2841:
2802:
2801:
2797:
2751:
2750:
2746:
2700:
2699:
2695:
2678:
2651:
2650:
2646:
2615:
2614:
2610:
2571:
2570:
2566:
2522:
2521:
2517:
2478:
2477:
2473:
2429:
2428:
2424:
2385:
2384:
2380:
2336:
2335:
2331:
2287:
2286:
2282:
2243:
2242:
2238:
2199:
2198:
2194:
2164:
2163:
2159:
2129:
2128:
2124:
2085:
2084:
2080:
2070:
2068:
2059:
2058:
2054:
2010:
2009:
2005:
1961:
1960:
1956:
1912:
1911:
1907:
1865:
1864:
1860:
1826:
1825:
1821:
1783:
1782:
1778:
1734:
1733:
1729:
1690:
1689:
1685:
1639:
1638:
1634:
1592:
1591:
1587:
1546:(4): e0174518.
1532:
1531:
1527:
1489:
1488:
1484:
1446:
1445:
1441:
1403:
1402:
1398:
1376:
1375:
1371:
1332:
1331:
1327:
1289:
1288:
1284:
1245:
1244:
1240:
1202:
1201:
1197:
1167:
1166:
1162:
1118:
1117:
1113:
1069:
1068:
1064:
1020:
1019:
1015:
971:
970:
966:
922:
921:
917:
873:
872:
868:
824:
823:
819:
775:
774:
770:
760:
758:
749:
748:
744:
700:
699:
695:
651:
650:
646:
602:
601:
597:
555:
554:
550:
516:
515:
511:
467:
466:
462:
418:
417:
413:
408:
356:
308:
279:
250:
247:
230:
217:
212:
181:Red bone marrow
162:
153:
144:
135:
118:
107:
98:
89:
81:
72:
64:
26:changes in the
17:
12:
11:
5:
3376:
3374:
3366:
3365:
3355:
3354:
3349:
3348:
3324:
3295:(12): 969–73.
3275:
3256:(4): 507–508.
3240:
3199:
3176:
3127:
3077:
3048:(4): 697–707.
3028:
2999:(4): 697–707.
2979:
2950:(6): 903–914.
2930:
2883:
2839:
2795:
2744:
2693:
2644:
2608:
2564:
2535:(5): 838–842.
2515:
2471:
2442:(5): 838–842.
2422:
2378:
2349:(5): 838–842.
2329:
2300:(5): 363–368.
2280:
2236:
2192:
2173:(1): 193–199.
2157:
2138:(1): 193–199.
2122:
2078:
2052:
2003:
1954:
1905:
1858:
1819:
1776:
1747:(6): 903–914.
1727:
1683:
1632:
1605:(5): 440–447.
1585:
1525:
1482:
1439:
1396:
1369:
1325:
1298:(2): 235–241.
1282:
1255:(2): 230–234.
1238:
1195:
1160:
1131:(2): 244–251.
1111:
1082:(3): 493–497.
1062:
1033:(2): 244–251.
1013:
984:(3): 493–497.
964:
935:(2): 244–251.
915:
886:(3): 493–497.
866:
837:(2): 244–251.
817:
788:(3): 493–497.
768:
742:
693:
644:
595:
548:
509:
480:(2): 244–251.
460:
410:
409:
407:
404:
403:
402:
397:
354:
349:
306:
277:
246:
243:
229:
226:
216:
213:
211:
208:
200:
199:
196:
192:
161:
158:
152:
149:
143:
140:
134:
131:
117:
114:
106:
103:
97:
94:
88:
85:
80:
77:
71:
68:
63:
60:
15:
13:
10:
9:
6:
4:
3:
2:
3375:
3364:
3361:
3360:
3358:
3344:
3340:
3337:(3–17): 1–9.
3336:
3328:
3325:
3320:
3316:
3312:
3308:
3303:
3298:
3294:
3290:
3286:
3279:
3276:
3271:
3267:
3263:
3259:
3255:
3251:
3244:
3241:
3236:
3232:
3227:
3222:
3218:
3214:
3210:
3203:
3200:
3195:
3191:
3187:
3180:
3177:
3172:
3168:
3163:
3158:
3154:
3150:
3146:
3142:
3138:
3131:
3128:
3123:
3119:
3114:
3109:
3105:
3101:
3097:
3093:
3089:
3081:
3078:
3073:
3069:
3064:
3059:
3055:
3051:
3047:
3043:
3039:
3032:
3029:
3024:
3020:
3015:
3010:
3006:
3002:
2998:
2994:
2990:
2983:
2980:
2975:
2971:
2967:
2963:
2958:
2953:
2949:
2945:
2941:
2934:
2931:
2926:
2922:
2918:
2914:
2910:
2906:
2902:
2898:
2894:
2887:
2884:
2879:
2875:
2871:
2867:
2863:
2859:
2855:
2851:
2843:
2840:
2835:
2831:
2827:
2823:
2819:
2815:
2811:
2807:
2799:
2796:
2791:
2787:
2782:
2777:
2772:
2767:
2763:
2759:
2755:
2748:
2745:
2740:
2736:
2731:
2726:
2721:
2716:
2712:
2708:
2704:
2697:
2694:
2689:
2683:
2675:
2671:
2667:
2663:
2659:
2655:
2648:
2645:
2640:
2636:
2632:
2628:
2624:
2620:
2612:
2609:
2604:
2600:
2596:
2592:
2588:
2584:
2580:
2576:
2568:
2565:
2560:
2556:
2551:
2546:
2542:
2538:
2534:
2530:
2526:
2519:
2516:
2511:
2507:
2503:
2499:
2495:
2491:
2487:
2483:
2475:
2472:
2467:
2463:
2458:
2453:
2449:
2445:
2441:
2437:
2433:
2426:
2423:
2418:
2414:
2410:
2406:
2402:
2398:
2394:
2390:
2382:
2379:
2374:
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2048:
2044:
2039:
2034:
2030:
2026:
2022:
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2014:
2007:
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1999:
1995:
1990:
1985:
1981:
1977:
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1969:
1965:
1958:
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1936:
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724:
720:
716:
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631:
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332:
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320:
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312:
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299:
295:
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288:(1): 177–86.
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177:trabeculae
142:Prevalence
133:Mechanical
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3231:S2CID
2970:S2CID
2921:S2CID
2897:Spine
2874:S2CID
2850:Spine
2830:S2CID
2806:Spine
2599:S2CID
2575:Spine
2506:S2CID
2482:Spine
2413:S2CID
2389:Spine
2271:S2CID
2247:Spine
2227:S2CID
2203:Spine
2113:S2CID
1896:S2CID
1872:Spine
1810:S2CID
1786:Spine
1767:S2CID
1718:S2CID
1694:Spine
1623:S2CID
1599:APMIS
1516:S2CID
1473:S2CID
1449:Spine
1430:S2CID
1360:S2CID
1336:SPINE
1316:S2CID
1292:Spine
1273:S2CID
1249:Spine
1229:S2CID
1205:Spine
1151:S2CID
1053:S2CID
955:S2CID
857:S2CID
586:S2CID
562:Spine
500:S2CID
32:spine
28:bones
3339:PMID
3307:PMID
3266:PMID
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3167:PMID
3118:PMID
3068:PMID
3019:PMID
2962:PMID
2913:PMID
2866:PMID
2822:PMID
2786:PMID
2735:PMID
2688:link
2670:PMID
2635:PMID
2591:PMID
2555:PMID
2498:PMID
2462:PMID
2405:PMID
2369:PMID
2320:PMID
2263:PMID
2219:PMID
2183:PMID
2148:PMID
2105:PMID
2073:2022
2043:PMID
1994:PMID
1945:PMID
1888:PMID
1849:PMID
1802:PMID
1759:PMID
1710:PMID
1674:PMID
1615:PMID
1576:PMID
1508:PMID
1465:PMID
1422:PMID
1387:PMID
1352:PMID
1308:PMID
1265:PMID
1221:PMID
1186:PMID
1174:32-A
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684:PMID
635:PMID
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492:PMID
451:PMID
389:PMID
341:PMID
298:PMID
269:PMID
48:disc
22:are
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3258:doi
3221:doi
3157:PMC
3149:doi
3108:PMC
3100:doi
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3058:PMC
3050:doi
3009:PMC
3001:doi
2952:doi
2905:doi
2858:doi
2814:doi
2776:PMC
2766:doi
2725:PMC
2715:doi
2662:doi
2627:doi
2623:104
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