title: Modic type I change may predict rapid progressive, deforming disc degeneration: a prospective 1-year follow-up study.
abstract: BACKGROUND
  This prospective magnetic resonance imaging (MRI) study in chronic low-back pain (CLBP) patients evaluated the natural course of degenerative lumbar spine changes in relation to Modic 1 type changes (M1) within 1 year.
  
  
  METHODS
  From 3,811 consecutive CLBP patients referred to lumbar spine MRI 54 patients with a large M1 were selected using strict exclusion criteria to exclude specific back disorders. Follow-up MRI was obtained within 11-18 months.
  
  
  RESULTS
  At baseline M1 was associated with an adjacent endplate lesion in 96% of the cases. In follow-up, an unstable M1 was associated both with an increase of endplate lesions, decrease of disc height and change in disc signal intensity, most found at L4/5 or L5/S1. In disc spaces without M1, progression of degenerative changes was rare.
  
  
  CONCLUSIONS
  Endplate deformation, decreasing disc height and change of disc signal intensity appear essential features of accelerated degenerative process associated with M1.
authors.affiliation: Department of Radiology, Helsinki University Central Hospital, Topeliuksenkatu 5, Helsinki, Finland. liisa.kerttula@hus.fi
authors.forename: Liisa
authors.initials: L
authors.lastname: Kerttula
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: Eeva
authors.initials: E
authors.lastname: Kääpä
mesh_terms: D000328:Adult; D000368:Aged; D002908:Chronic Disease; D018450:Disease Progression; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D055959:Intervertebral Disc Degeneration / Q000150:complications / Q000473:pathology*; D017116:Low Back Pain / Q000209:etiology / Q000473:pathology*; D008159:Lumbar Vertebrae / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D055815:Young Adult