Modic signs are the pathological changes that are present in the bones of the spine and vertebrae. This term is used to describe changes in the spinal plate that are related to spinal degeneration.. Here we will show you the types, Causes, more frequent diagnosis and treatments.
These changes are closely related to the normal degenerative process that affects the lumbar spine., and its prevalence increases with age. Nevertheless, the exact pathogenesis underlying these changes and their relationship to lumbar spine segmental instability and low back pain remain unclear.
Modic signs can only be seen on MRI scans and can appear on both the vertebra and the endplate of neighboring discs. This disease process is associated with spinal inflammations that have not been extremely effective for normal treatments..
These changes will be seen as an alteration of the signal on the end plates parallel to the disk.. They are most common in the lumbar spine, although they can occur at any level. They are common in patients with low back pain in a 18-58% and is strongly associated with LBP.
In asymptomatic people, the predominance is 12-13%. Modic signs are divided into three different types. The type 1 consists of fibrovascular tissue, the type 2 it's yellow fat and the guy 3 is sclerotic bone. The temporal evolution of this condition is uncertain, but the time span is years.
Index
Types of modic signs
exist 3 types of modic signs, these are: Guy 1 (T1), Guy 2 (T2) and Type 3 (T3).
Guy 1: Represents acute degenerative fibrovascular changes in the subchondral bone marrow, such as edema and inflammation, associated with pain. In this type, there is vascular development in the vertebral bodies, but there are no changes in the bone marrow, seen on MRI.
Guy 2: It is the replacement of marrow by visceral fat. In this type, additional changes occur in the bone marrow, seen with fat replacement rather than the normal appearance of the bone marrow.
Guy 3: It is an extremely rare condition, representing bone replacement by bone sclerosis, where there is little residual marrow. What's more, fractures and shortening of the trabecular bone may occur. The changes are usually visible through radiological examinations and some patients show signs of end-plate sclerosis.
Importance of modic signs in back pain
Modic signs are one of the main causes of low back pain, low spinal stenosis or herniated disc. Studies suggest that there is a strong relationship between modic signs and back pain, especially the type 1.
Studies also suggest that people with modic signs, have the same symptoms as people who have back pain due to other conditions. More than 80% of people with modic signs, have constant back pain, which means there is not a single moment without pain. In some cases, pain can interfere with the individual's sleep.
Modic signs are diagnosed through magnetic resonance imaging MRI scans. Through this study, patients with chronic and disabling back pain, can get a diagnosis of these changes.
And MRI, modic signs will be seen as a signal disturbance on end plates parallel to the disk. They are most common in the lumbar spine, but they can occur at any level. They commonly occur in the anterior part, but there are also cases in which there is almost complete vertebral involvement.
Possible pathogenetic mechanisms causing modic signs
There are two possible pathogenetic mechanisms that cause the modic signs.. These are:
Mechanics
The disc degeneration causes loss of soft nuclear material, reduction of disc height and hydrostatic pressure, which increases the shear forces on the end plates and micro fractures can occur.
Bacterial
Anaerobic bacteria enter the anaerobic disc and in this environment cause an infection. This develops slowly after a break in the outer fibers of the ring, for instance, a herniated disc. Causing re-capillarization and inflammation around the extruded nuclear material.
Treatment for modic signs
Treatment for patients with back pain, caused by diseases of the modic type sign 2 and 3, it's not easy at all. The type 1 and 2 it is treated with a conservative and preventive procedure. In most cases these treatments only relieve symptoms.
The normal treatments used to improve back pain, does not cure changes caused by modic signs. The best method to treat back pain symptoms caused by modic signs, is a diligent exercise regimen to strengthen back muscles and improve flexibility.
This exercise regimen must be proposed by a physical therapist. After completing physical therapy, a regimen of physical exercises is continued, that the patient must do constantly. Exercises must be supervised by a specialist, in some cases an increase in pain may occur.
Back pain is treated with anti-inflammatory drugs and rarely opioids. If you have paravertebral muscle pain and muscle spasm, it can be treated with muscle relaxants. Stretching and strengthening the back muscles is achieved with daily exercises.