J Korean Neurosurg Soc.  2013 Jul;54(1):34-37. 10.3340/jkns.2013.54.1.34.

Modic Degenerative Marrow Changes in the Thoracic Spine : A Single Center Experience

• Lee JM
• Nam KH
• Lee IS
• Park SK
• Choi BK
• Han IH

• KMID: 2190855
• DOI: http://doi.org/10.3340/jkns.2013.54.1.34

Abstract

OBJECTIVE
The purposes of this study were to evaluate the prevalence, types, and locations of Modic changes (MCs) in the thoracic spine in a large number of subjects, and to investigate the relation between the distributions of MCs and disc herniations (DHs) in the thoracic spine.
METHODS
Two experienced musculoskeletal radiologists assessed the presence of MCs and DHs by consensus in the thoracic MRIs of 144 patients with non-specific back pain. Patient ages ranged from 22 to 88 years (mean=53.3+/-14.66 years), and 72 were female (50%). The prevalence, distribution, relation of MCs and DHs was recorded.
RESULTS
MC was observed in 8 of the 144 patients (5.6%) and 10 of 1728 segments (0.58%). The most common MC was type II. Of the 8 patients exhibiting MC, 6 had type II (75.0%), and 2 had mixed MCs (type I/II or type II/III). MCs were distributed mainly at the mid-thoracic level (from T5/6 to T9/10). DH was detected in 18 patients (12.5%), 36 of 1728 segments (2.1%). Of the 10 segments exhibiting MC, 5 had DHs at the same level (50.0%). Accordingly, DH was strongly associated with MC (p=0.000).
CONCLUSION
A low prevalence of MC was observed in the thoracic spine, and type II MC predominated. The low prevalence of MC in the thoracic spine suggests that it was caused by a relative lack of mobility as compared with the cervical and lumbar spines. And DHs were found to be strongly associated with MCs even in the thoracic spine.

Keyword

Prevalence; Modic change; Thoracic spine; Disc herniation

MeSH Terms

Back Pain
Bone Marrow
Consensus
Humans
Prevalence
Spine

Figure

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  Fig. 1 Thoracic MRI of a 73-year-old man with mixed type Modic change (type I/II) at T9-10. A : Sagittal T1-weighted image revealing high signal intensity of the lower endplate of T9 and low signal intensity of the upper endplate of T10. B : Sagittal T2-weighted image showing high signal intensity of both endplates at T9-10.

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  Fig. 2 Distribution of modic changes and disc herniations in the thoracic spine. MC : Modic change, DH : disc herniation.

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  Fig. 3 Thoracic MRI of an 80-year-old woman exhibiting a type II Modic change and disc herniation at T8-9.

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