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Vertebral endplate and marrow changes - Modic classification

Classification

Type I

  • MRI appearance: Hypointense on T1, hyperintense on T2
  • Likely inflammatory in origin, seem to be strongly associated with active low back pain and segmental instability, appear to predict excellent outcome following lumbar fusion

Type II

  • MRI appearance: Hyperintense on T1, iso-hyperintense on T2
  • Less clearly associated with low back pain, seem to indicate a more biomechanically stable state; superimposed stress may cause reversion to type I

Type III

  • MRI appearance: Hypointense on T1, hypointense on T2
  • Exact nature and pathogenetic significance largely unknown

Explanation

Classification scheme for signal intensity changes in the bone marrow adjacent to the vertebral endplates in degenerative spine disease

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