Modic classification

Vertebral endplate and marrow changes

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 and 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 significane largely unknown

    • Reference

    Rahme R, Moussa R. The modic vertebral endplate and marrow changes: pathologic significance and relation to low back pain and segmental instability of the lumbar spine. AJNR Am J Neuroradiol. 2008 May;29(5):838-842.