Modic Vertebral Body Changes The Natural History as Assessed by Consecutive Magnetic Resonance Imaging
Modic Vertebral Body Changes The Natural History as Assessed by Consecutive Magnetic Resonance Imaging
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DOI：
10.1097/brs.0b013e31821604b6
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发表时间：
2011-12-15
期刊：
影响因子：
3
通讯作者：
Sharp, David J.
中科院分区：
文献类型：
--
作者：
Hutton, Michael J.;Bayer, Jens H.;Sharp, David J.
研究设计。临近终板的椎体改变可能与退变性椎间盘疾病有关。这些变化可以在磁共振成像（MRI）上分离，并已被Modic描述。假设这些终板的变化代表了一个渐进的过程。我们回顾性地回顾了连续进行腰椎MRI检查的患者，以研究Modic椎体MRI变化的自然历史。背景资料摘要。在第一次MRI中36例Modic 1型改变的终板中，18例保持不变，13例发展为Modic 2型改变，3例发展为Modic 3型改变，2例在随后的MRI中发现正常（0型）。在第一次MRI中最初报告为Modic 2型的22例终板中，18例保持不变，没有一例转化为Modic 3型，4例在随后的MRI中从Modic 2型转化为Modic 1型。一位资深脊柱外科医生评估了49例受试者的腰椎磁共振（MR）图像。采用Modic系统对临近终板的腰椎椎体从L1到S1包括进行分类。在第一个数据集中，Modic 1变化的36个端板中，18个保持不变；13个发展到mod 2；3个进展到Modic 3变化，有趣的是，在重复扫描中发现2个端板正常。在最初报告为Modic 2的22个端板中，18个保持不变；没有转换为Modic 3和4从Modic 2转换回Modic 1。我们的研究结果反映了脊柱病理变化的动态性质，并证明了Modic变化是可逆的。他们还提出了进一步的疑问，这些MRI变化应作为临床症状或手术结果的指标。
Study Design. Changes in the vertebral body adjacent to the end plate may be associated with degenerative disc disease. These changes can be separated on magnetic resonance imaging (MRI) and have been described by Modic. It is assumed that these end plate changes represent a process that is progressive.Objective. We have retrospectively reviewed patients who had sequential MRI of the lumbar spine to investigate the natural history of Modic vertebral body MRI changes.Summary of Background Data. Of 36 end plates with Modic type 1 changes in a first MRI, 18 remained the same, 13 progressed to Modic type 2 change, 3 progressed to Modic type 3 changes, and 2 end plates were found to be normal (type 0) on a subsequent MRI. Of the 22 end plates initially reported as Modic type 2 in a first MRI, 18 remained unchanged, none converted to Modic type 3, and 4 converted from Modic type 2 to Modic type 1 on a subsequent MRI.Methods. Magnetic resonance (MR) images of the lumbar spine of 49 subjects were assessed by a senior spinal surgeon. The lumbar vertebral body adjacent to the end plate was classified by using the Modic system from L1 to S1 inclusive.Results. Of the 36 end plates with Modic 1 changes in the first data set, 18 remained the same; 13 progressed to Modic 2; 3 progressed to Modic 3 changes, and, interestingly, 2 end plates were found to be normal on the repeat scan. Of the 22 end plates initially reported as Modic 2, 18 remained unchanged; none converted to Modic 3 and 4 converted back from Modic 2 to Modic 1.Conclusion. Our findings reflect the dynamic nature of pathological changes in the spine and have demonstrated that Modic changes are reversible. They also raise further doubt that these MRI changes should be used as an indicator of clinical symptoms or of surgical outcome.