title: Relationship of Modic type 1 change with disc degeneration: a prospective MRI study.
abstract: OBJECTIVE
  The objective was to study the natural course of Modic type 1 change (M1) in relation to lumbar disc degeneration.
  
  
  METHODS
  Twenty-four chronic low back pain (LBP) patients with M1 on lumbar spine were selected from 1,015 patients with magnetic resonance imaging from a follow-up study lasting for 18-74 months. Exclusion criteria were any other specific back disorder, age >or=60 years, or a recent spine operation. The association between the development of M1 and degenerative disc changes was studied using multivariate modeling (complex samples logistic regression).
  
  
  RESULTS
  At baseline, 20 of 28 (71%) disc spaces with M1 had a decreased disc height (DH) and 16 of 28 (57%) a dark nucleus pulposus, but ten of 28 (36%) a very dark annulus fibrosus and a paradoxically bright nucleus pulposus albeit decreased DH. During follow-up, DH decreased in 13 of 28 (46%) and signal intensity of nucleus pulposus (DSI) in eight of 28 (29%) disc spaces with M1, but it increased in four (14%) discs. In those without M1, only few changes occurred. The larger the M1, the more likely was the DH low or decreased further. Both the presence and changes in M1 were associated with a decrease in DH and changes in DSI and bulges.
  
  
  CONCLUSIONS
  The degenerative process in discs with adjacent M1 seems to be accelerated and leads to advanced and deforming changes with special morphologic features. M1 may be a sign of a pathologic degenerative process in the discovertebral unit.
authors.affiliation: Helsinki and Uudenmaa District University Hospitals, Helsinki University Central Hospital, HUS-röntgen, PL 340, 00029 HUS, Helsinki, Finland. katariina.luoma@hus.fi
authors.forename: Katariina
authors.initials: K
authors.lastname: Luoma
authors.forename: Tapio
authors.initials: T
authors.lastname: Vehmas
authors.forename: Mats
authors.initials: M
authors.lastname: Grönblad
authors.forename: Liisa
authors.initials: L
authors.lastname: Kerttula
authors.forename: Eeva
authors.initials: E
authors.lastname: Kääpä
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007403:Intervertebral Disc / Q000473:pathology*; D007405:Intervertebral Disc Displacement / Q000473:pathology*; D016015:Logistic Models; D008159:Lumbar Vertebrae / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies