From: William J Owens Jr DC DAAMLP
Understanding the difference between and ACUTE or CHRONIC injury to the spine is a critical part of proper spine care. One of the ways to do that is to use the Modic scale to determine how long a reactive process has been present in the spine.
Here is a very brief reference sheet to help you. REMINDER – you need to review BOTH the T1 and the T2 weighted images to determine the Modic criteria.
Diagnosing modic changes
- In Modic type 1 there is vascular development in the vertebral body, with findings of inflammation and edema, but no trabecular damage or marrow changes.
- In Modic type 2 there are changes in bone marrow, with fatty replacement of formerly red, cellular marrow normally seen there. With Modic type 2 changes the marrow is substituted by visceral fat, the same kind of fat we have on our hips and bellies.
- Modic Changes type 3 are less common, with fractures of the trabecular bone, along with trabecular shortening and widening.
- Modic MT, Masaryk TJ, Ross JS, Carter JR (1988). “Imaging af degererative disk disease”. Radiology. 168: 177–86. doi:10.1148/radiology.168.1.3289089.
- Albert HB (2008). “Modic changes, possible causes and relation to low back pain.”.”. Med Hypotheses. 70 (2): 361–8. PMID 17624684. doi:10.1016/j.mehy.2007.05.014.
- Albert HB (Jul 2007). “Modic changes following lumbar disc herniation.”.”. Eur Spine J. 16 (7): 977–82. PMC . PMID 17334791. doi:10.1007/s00586-007-0336-8.