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AJNR - American Journal of Neuroradiology

Published ahead of print on February 13, 2008
doi: 10.3174/ajnr.A0925

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American Journal of Neuroradiology 29:838-842, May 2008
© 2008 American Society of Neuroradiology

Review Article

The Modic Vertebral Endplate and Marrow Changes: Pathologic Significance and Relation to Low Back Pain and Segmental Instability of the Lumbar Spine

R. Rahme^a and R. Moussa^a

^a From the Department of Neurosurgery, Saint-Joseph University and Hôtel-Dieu de France, Beirut, Lebanon

Please address correspondence to Ralph Rahme, MD, Department of Neurosurgery, Hôtel-Dieu de France, Ashrafieh, Beirut, Lebanon; e-mail: rrahme{at}waln.org

SUMMARY: Two decades following their description, the significance of Modic vertebral endplate and marrow changes remains a matter of debate. These changes are closely related to the normal degenerative process affecting the lumbar spine, and their prevalence increases with age. However, the exact pathogenesis underlying these changes and their relation to segmental instability of the lumbar spine and to low back pain remain unclear. In this paper, we review the literature relevant to this topic and discuss the currently available evidence regarding the pathologic and clinical significance of Modic changes.