ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2015
Modic (endplate) changes in the lumbar spine: bone micro-architecture and remodelling.
Article in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 47 papers, 1 of them a synthesis that pooled it.
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Who cites it
47 citing papers in PubMed, 1 synthesis or guideline pooled it, 90 citations in OpenAlex.
- Pathobiology of Modic changes.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2016Pooled it
- Association of Modic change types and their short tau inversion recovery signals with clinical characteristics- a cross sectional study of chronic low back pain patients in the AIM-study.BMC musculoskeletal disorders · 2020Trial
- Trial
- Comparison of radiomics-based models for detection of Modic type 1 changes in photon-counting detector CT images of the lumbar spine.Skeletal radiology · 2026Article
- Quantitative Disk and Metabolic Bone PET-MRI for Understanding Disk-Endplate Crosstalk in Degeneration of the Lumbar Spine.JOR spine · 2026Article
- IntradiscalJOR spine · 2026Article
- Association of preoperative co-occurring intervertebral disc-related degenerative features with one-year lumbar discectomy outcomes: A proposal for and preliminary testing of a novel MRI-based criterion.European journal of radiology open · 2026Article
- GDF15 induces excessive activation of osteoclasts within the vertebral endplates leading to early endplate degeneration.JCI insight · 2026Article
- Bone remodeling, not inflammation, as the predominant pathology in modic type 1 lesions of the lumbar spine.Pain medicine (Malden, Mass.) · 2026Article
- Vanishing vacuum disc phenomenon: A diagnostic key in spinal infection.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2025Article
- Modic Changes as Biomarkers for Treatment of Chronic Low Back Pain.Biomedicines · 2025Review
- Modic Changes in Patients Who Have Undergone Anterior Cervical Discectomy and Fusion: The Correlation With Fusion Success and Subsidence.Orthopaedic surgery · 2025Article
- Modic changes: From potential molecular mechanisms to future research directions (Review).Molecular medicine reports · 2025Review
- Association between bone mineral density and lower back pain in the general United States population using the NHANES of 1999-2004.Frontiers in surgery · 2025Article
- Back pain symptom relieved by tubular lumbar microdiscectomy.Frontiers in surgery · 2025Article
- Can Hematological Inflammatory Indices Be Used to Differentiate Modic Type 1 Changes from Brucella Spondylodiscitis?Medicina (Kaunas, Lithuania) · 2024Article
- Risk factors for early-onset adjacent segment degeneration after one-segment posterior lumbar interbody fusion.Scientific reports · 2024Article
- No evidence of association between either Modic change or disc degeneration and five circulating inflammatory proteins.JOR spine · 2024Article
- Review
- Cartilaginous endplates: A comprehensive review on a neglected structure in intervertebral disc research.JOR spine · 2023Review
Corrections and comments
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Authors and funding
6 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeIn the literature, inter-vertebral MRI signal intensity changes (Modic changes) were associated with corresponding histological observations on endplate biopsies. However, tissue-level studies were limited. No quantitative histomorphometric study on bone biopsies has yet been conducted for Modic changes. The aim of this study was to characterise the bone micro-architectural parameters and bone remodelling indices associated with Modic changes.
methodsForty patients suffering from disabling low back pain, undergoing elective spinal surgery, and exhibiting Modic changes on MRI (Modic 1, n = 9; Modic 2, n = 25; Modic 3, n = 6), had a transpedicular vertebral body biopsy taken of subchondral bone. Biopsies were first examined by micro-CT, for 3D morphometric analysis of bone volume fraction (BV/TV), trabecular thickness (Tb.Th), trabecular separation, trabecular number, and structure model index. Then, samples underwent histological analysis, for determination of bone remodelling indices: osteoid surface to bone surface ratio (OS/BS), eroded surface to bone surface (ES/BS) and osteoid surface to eroded surface ratio (OS/ES).
resultsMicro-CT analysis revealed significantly higher BV/TV (up to 70% increase, p < 0.01) and Tb.Th (up to +57%, p < 0.01) in Modic 3 biopsies, compared to Modic 1 and 2. Histological analysis showed significantly lower OS/BS in Modic 2 biopsies (more than 28% decrease, p < 0.05) compared to 1 and 3. ES/BS progressively decreased from Modic 1 to 2 to 3, whereas OS/ES progressively increased with significantly higher values in Modic 3 (up to 159% increase, p < 0.05) than in Modic 1 and 2.
conclusionsSignificant differences were found in bone micro-architectural parameters and remodelling indices among Modic types. Modic 1 biopsies had evidence of highest bone turnover, possibly due to an inflammatory process; Modic 2 biopsies were consistent with a reduced bone formation/remodelling stage; Modic 3 biopsies suggested a more stable sclerotic phase, with significantly increased BV/TV and Tb.Th compared to Modic 1 and 2, linked to increased bone formation and reduced resorption.
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