Zhang Jeffrey, Bellow Emily, Bae Jennifer, Johnson Derek, Bajrami Sandi, Torpey Andrew, Caldwell William
Renaissance School of Medicine, Stony Brook University, Stony Brook, NY 11794, USA.
Department of Anesthesiology, Stony Brook University Hospital, Stony Brook, NY 11794, USA.
Biomedicines. 2025 Jul 11;13(7):1697. doi: 10.3390/biomedicines13071697.
Chronic low back pain (CLBP) is the leading cause of disability both within the United States and globally. However, reliable diagnosis and treatment remains limited due to a lack of objective and image-based biomarkers. Modic changes (MCs) are visible vertebral endplate and bone marrow changes in signal intensity seen on MRI. MCs have emerged as promising correlates with degenerative disc disease and CLBP. This is a non-systematic literature review. This review synthesizes current evidence on the classification, pathophysiology, and imaging of MCs, with a particular focus on their associations with patient-reported outcomes, including pain (Visual Analog Scale), functional status (Oswestry disability index and Roland-Morris Disability Questionnaire), and health-related quality of life (Short Form-36 and EuroQol 5-Dimension 5 Level). MC type 1 and 2 show significant correlations with symptom severity and predict positive response to basi-vertebral nerve (BVN) ablation, a minimally invasive intervention inhibiting the nerves' ability to transmit pain signals. Across multiple trials, BVN ablation has shown significant sustained improvements in patient-reported outcomes among patients with MC, reinforcing their role as both a diagnostic and therapeutic biomarker.
慢性下腰痛（CLBP）是美国乃至全球致残的主要原因。然而，由于缺乏客观的、基于影像的生物标志物，可靠的诊断和治疗方法仍然有限。Modic改变（MCs）是在MRI上可见的椎体终板和骨髓信号强度变化。MCs已成为与椎间盘退变和CLBP相关的有前景的指标。这是一篇非系统性文献综述。本综述综合了关于MCs分类、病理生理学和影像学的当前证据，特别关注它们与患者报告结局的关联，包括疼痛（视觉模拟量表）、功能状态（Oswestry残疾指数和Roland-Morris残疾问卷）以及健康相关生活质量（简明健康调查问卷36项和欧洲五维健康量表）。1型和2型MCs与症状严重程度显著相关，并预测对椎基神经（BVN）消融术（一种抑制神经传递疼痛信号能力的微创干预）有阳性反应。在多项试验中，BVN消融术已显示出在患有MCs的患者中，患者报告结局有显著持续改善，强化了它们作为诊断和治疗生物标志物的作用。
