Article reviewed and approved by Dr. Ibtissama Boukas, physician specializing in family medicine
The Modic signals describe the endplate changes related to spinal degeneration (degenerative disc disease). Find out everything there is to know about this subject in this article.
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Definition of Modic changes
The Modic changes are bone marrow damage observed in a vertebral body withMagnetic resonance imaging (MRI). It is generally suggested that they are associated with a lumbago. They are especially present in patients receiving medical care for low back pain.
THEIRM shows signal strength changes during the degeneration process. It is usually about fat,edema or sclerosis. THE Modic changes are seen as a dynamic process that can change and progress.
The different signs of Modic
On MRI, Modic's signs will resemble signal alteration in the endplates parallel to the intervertebral disc. They are more common in lumbar spine and, although they can occur at any level, they most often affect the vertebraeL4-L5 (between the 4e and 5evertebrate lumbar) and L5-S1 (between the 5e lumbar vertebra and the 1re sacral vertebra).
Where changes occur is also variable. They usually occur forward. However, there are also cases where there is almost complete vertebral involvement.
There are three types of Modic changes:
Modic 1
Le type I represents the fibrovascular changes in the bone marrow subchondral such as theedema and l'inflammation.
It refers to the acute degenerative changes who are often associated with pain. These images will show high signal intensity on T2 images and low signal intensity on T1 images.
Modic 2
This guy represents the replacement of bone with fatty yellow marrow. It can be distinguished by increased signal intensity in T1 and T2 images.
Modic 3
Le modic 3 represents replacement of bone by bone sclerosis where there is little residual marrow.
In this case, we observe a condensation of the subchrondral bone with an increase in the density of the bone present under the vertebral plate. Sclerotic changes will also be visible in cases of osteoarthritis. There is low signal intensity on the T1 and T2 images.
Common Causes of Modic Signal
The Modic changesI-type are present in 4% of patients undergoing MRI for disc disease.
Type II is present in 16% of patients and type III is the least common (1% of cases).
La because of theseendplate changes is largely unknown.
Modic has created a diagnostic system, however, research continues to assess the probable causes of these changes as well as the prevalence and association of these changes with pain.
Specific factors
There are different parameters that are considered to be factors in the development of modic signs. We can cite :
la disc degeneration particularly related to age: it causes them to dry out and makes them increasingly vulnerable to shocks;
daily activities and sports : these cause tears in the outer core of the disc. Beyond the age of 60, most people have some degree of disc degeneration. However, not everyone at this age has back pain;
the wounds which can cause a swelling, a pain and lumbar instability. This can lead to low back pain.
Since its very first discovery by the Dr. Michael Modic in 1988, the Modic changes have already been the subject of much research.
Although the causes and mechanisms responsible for the formation of Modic are still poorly understood, progress is being made to link his spinal phenotype to disc degeneration and low back pain. This is important because currently the value of MRI in the low back pain management remains low due to the absence of phenotypic characteristics strongly correlated with clinical symptoms.
The prevalence and association of Modic changes with back pain concluded that well that there is a link between changes on MRI and back pain, there are also asymptomatic people who show these features on MRI.
Proposed risk factors for the development of Modic changes include:
classification of the body mass index (BMI) of people in overweight or obese;
advanced age ;
Diagnostic procedures
MRI is the best method for diagnosing Modic changes, but X-ray imaging is also useful in differentiating spondyloarthropathy.
MRI is useful for view end plate modifications : early changes in edema et fat replacement.
On the other hand, in X-rays, only type III sclerotic changes can be observed. But with MRI, and especially with the comparison of T1 and T2 images, a lot of information can be gathered about suspected changes occurring in the spine.
Radiologists should consider a differential diagnosis such as:
Evolution and progression over time of Modic signs
The Modic types form a continuum along which the disease process will progress. An estimate of 18 to 24 months has been provided for the transition from the Type I to Type II form, although others feel that much larger longitudinal studies are needed to substantiate this idea.
Some studies suggest that with age, type II changes become more frequent in the cervical spine and lumbar, describing Modic changes as a dynamic phenomenon. Thus, type I changes may progress to type II over time.
Type I and II changes have a high specificity (greater than 90%)but a low sensitivity (20 to 30%) for sore lumbar disc. This means that despite the high prevalence of Modic changes, there is a small percentage of people with severe disc degeneration who have a persistent and high level of pain.
On the other hand, there are people (35%) who present changes degenerative discs, but suffer no pain.
Modic Changes Treatment and Healing
La disc degeneration is a age-related process et not a pathological process and therefore should not be a painful problem. It can be accelerated in some cases and is considered a pathology. However, in general, many people experience changes that are only associated with age.
It is possible that a basic non-invasive treatment for low back pain is no more effective than reduced activity and relative rest.
However, some low back pain patients Modic sufferers always report feeling a moderate pain intensity at 6-month follow-up despite treatment.
Knowing the link between Modic signs and back pain can therefore be beneficial for the patient. This will influence education and goal setting.
It is also important for planning resource intensity and discussing risk/benefit when obtaining informed consent for a rehabilitation intervention.
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What about natural remedies?
Although they are not supported by solid scientific evidence, several natural products and home remedies are used to treat various body pains, especially for their anti-inflammatory power.
Here is a non-exhaustive list of plants and essential oils that are effective in controlling pain and inflammation:
Turmeric : Thanks to its antioxidant and anti-inflammatory powers very powerful, turmeric is one of the most used plants in a culinary and therapeutic context. The composition of turmeric is essentially made of essential oils, vitamins (B1, B2, B6, C, E, K) and trace elements. But it is to its composition rich in curcumin and curcuminoids that we owe them and calm skin of this spice.
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Ginger : In addition to the special flavor it brings to the kitchen and its aphrodisiac properties, ginger is a root well known for its anti-inflammatory powers. THE gingerol gives it its anti-inflammatory action. It is an active component acting on the inflammatory pain related to chronic joint inflammatory diseases, including rheumatoid arthritis, lupus, rheumatic diseases, etc. It has been proven that this active element is also effective in acting on the inflammation linked to arthritis and sciatica. Ginger also has other benefits thanks to its high potassium content and its richness in trace elements (calcium, magnesium, phosphorus, sodium) and vitamins (provitamin and vitamin B9).
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Lemon eucalyptus: Eucalyptus is a plant most often used in the form of herbal tea or essential oil. She would have anti-inflammatory effects which give it the ability to act on the bone and joint pain in general and the pain of sciatica in particular.
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wintergreen : Wintergreen is a shrub from which a very interesting essential oil is extracted. It is one of the most used essential oils in aromatherapy. This oil extracted from the shrub bearing the same name, is used in massage to relieve sciatica and act like a analgesic. Indeed, it provides a heating effect thanks to its ability toactivate blood circulation locally.
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Remember that these products do not replace medical treatment. Do not hesitate to consult for support adapted to your condition.
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My name is Arotoky and I am studying human medicine. Web editor for more than 5 years, I currently focus on the theme of health and well-being. I have the strong conviction that with my valuable articles, I can help many people to relieve their ailments and feel better. My goal is to share my health knowledge with the general public through web writing.
