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


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


Insert figures illustrating the classification


Provide the citation for the landmark article and recent review articles describing the classification