Diagnosis and Treatment Options for Modic Type II Changes
Modic Type II Changes are relatively common in patients with chronic neck or back conditions. The Modic Type II changes always accompany degenerative disc disease as well as spinal disc disorders such as bulging discs and herniated discs (Slipped Disc or Slip-DIsc). Patients presenting with Modic Type changes require accurate diagnosis and targeted non-surgical treatment. In this section of our website, we will familiarize you with Modic Type II Changes and the best means of targeted therapy without injections or surgery.
There are three types of Modic changes that are being discussed in the literature, Modic Type I, Modic Type II and Modic Type III. Each of these Modic changes represents a different underlying structural lesion at the adjacent endplates of the vertebrae. Modic Type I changes are commonly associated with lower back pain as acute inflammatory process and with bone marrow swelling. Whereas fatty replacement of the normal red bone marrow is seen with Modic Type II changes. Modic Type II changes are the result of reduced blood flow to the affected bone marrow. The Modic Type III changes are not that commonly seen, but they represent increased bone formation adjacent to the cartilage of the affected spinal segment or known as subchondral sclerosis.
Modic Type I, Modic Type II Changes and Degenerative Disc Disease
Most of the Modic Type I changes will progress into Modic Type II changes over a period. Modic Type II changes are commonly associated with degenerative disc disease. Degenerative Disc Disease includes a broad spectrum of signs and symptoms and radiological features such as disc protrusion, disc herniation, reduced disc height and Hypertrophy of Ligamentum Flavum. However, there is some evidence showing the relationship between reduced disc height and Type II Modic changes. These Modic changes can be seen in the adjacent vertebrae of the lower lumbar spine, and sometimes they may affect the average disc height of the lumbar spine.
Intervertebral disc is made up of fibrocartilage with very little or no direct blood supply. It is proposed that this fatty replacement of the bone marrow at the endplates of the adjacent vertebrae may reduce the nutritional supplies to the intervertebral disc. This will, in turn, lead to early onset degeneration of the disc and reduced disc height.
How to Avoid Modic Changes?
Reduced disc height is proposed theory that may explain the association of Modic changes and the development of moderate to severe back pain. A reduction in disc height (degenerated spinal discs) leads to the loss of the expected cushioning effect of the intervertebral disc as a result. vertebral end-pates are placed under excessive stresses. These stresses are key factors in the development of back pain, slipped disc and Modic Changes in the spine. The associated axial compression load will be redistributed to the adjacent vertebrae and lead to Modic changes. However, there is no evidence to show whether the reduced disc height is a cause or result of Modic changes. None-the-less, those that have back pain are strongly encouraged to a obtain targeted treatments to avoid damaging of spinal discs, spinal end-plates or the subchondral bone. As such, early-targeted treatments can prevent the formation of Modic changes.
Modic Type I and lead to Modic Types II and III. Therefore, the best method of treatments is through a holistic approach that minimizes the impacts of a Modic Type I. As we have mentioned, Modic Type I are inflammatory processes that have influenced the vertebral end-late as well as the subchondral bony attachment of the given end-plate. Therefore, the most effective means of avoiding or hopes of recovery are treatments that target the causes of Modic changes. To date published literature, point to disc degenerations as the culprit in Modic Types I, II and III. In other words, the reason you got a Modic change in your spine is likely due to chronic back issues that were neglected. Therefore to avoid or correct them, care given must target the degenerative changes.
Modic Changes (Type I, II and III), Degenerative Disc Disease and NSD Therapy
In our centers, we treat degenerated discs, slipped discs and those that present with Modic Types I, II, and II through a collaborative advanced method of chiropractic, targeted physiotherapy and therapy devices such as the RxDecom. This combined method of care is termed as NSD Therapy®.
References for Modic Type II
Teichtahl AJ, Urquhart DM, Wang Y, et al. Modic changes in the lumbar spine and their association with body composition, fat distribution and intervertebral disc height – a 3.0 T-MRI study. BMC Musculoskeletal Disorders. 2016;17:92. doi:10.1186/s12891-016-0934-x.
The above reference is one of our research sources for Modic type II changes.