The DOI matches its Crossref record; 64 of the 64 references it cites were found in a registry or an index.
Pathobiology of Modic changes
Open accessAbstract
PurposeLow back pain (LBP) is the most disabling condition worldwide. Although LBP relates to different spinal pathologies, vertebral bone marrow lesions visualized as Modic changes on MRI have a high specificity for discogenic LBP. This review summarizes the pathobiology of Modic changes and suggests a disease model.MethodsNon-systematic literature review.ResultsChemical and mechanical stimulation of nociceptors adjacent to damaged endplates are likely a source of pain. Modic changes are adjacent to a degenerated intervertebral disc and have three generally interconvertible types suggesting that the different Modic change types represent different stages of the same pathological process, which is characterized by inflammation, high bone turnover, and fibrosis. A disease model is suggested where disc/endplate damage and the persistence of an inflammatory stimulus (i.e., occult discitis or autoimmune response against disc material) create predisposing conditions. The risk to develop Modic changes likely depends on the inflammatory potential of the disc and the capacity of the bone marrow to respond to it. Bone marrow lesions in osteoarthritic knee joints share many characteristics with Modic changes adjacent to degenerated discs and suggest that damage-associated molecular patterns and marrow fat metabolism are important pathogenetic factors. There is no consensus on the ideal therapy. Non-surgical treatment approaches including intradiscal steroid injections, anti-TNF-α antibody, antibiotics, and bisphosphonates have some demonstrated efficacy in mostly non-replicated clinical studies in reducing Modic changes in the short term, but with unknown long-term benefits. New diagnostic tools and animal models are required to improve painful Modic change identification and classification, and to clarify the pathogenesis.ConclusionModic changes are likely to be more than just a coincidental imaging finding in LBP patients and rather represent an underlying pathology that should be a target for therapy.
Overview
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Citations
Cites
Vos, T., Flaxman, A. D., Naghavi, M., Lozano, R., Michaud, C., Ezzati, M., Shibuya, K., Salomon, J. A., Abdalla, S., Aboyans, V., et al. (2012) · The Lancet · doi:10.1016/s0140-6736(12)61729-2 · Cited by 8,291
Degenerative disk disease: assessment of changes in vertebral body marrow with MR imaging.
Modic, M. T., Steinberg, P. M., Ross, J. S., Masaryk, T. J., & Carter, J. R. (1988) · Radiology · doi:10.1148/radiology.166.1.3336678 · Cited by 2,061
Role of advanced glycation end products in cellular signaling
Ott, C., Jacobs, K., Haucke, E., Navarrete Santos, A., Grune, T., & Simm, A. (2014) · Redox Biology · doi:10.1016/j.redox.2013.12.016 · Cited by 1,150 · cited 8×
“Higher serum lipid concentration also enhances lipid peroxidation, a process resulting in increased advanced-glycation end products (AGE) [84].”
BackgroundInfluentialBone-marrow adipocytes as negative regulators of the haematopoietic microenvironment
Naveiras, O., Nardi, V., Wenzel, P. L., Hauschka, P. V., Fahey, F., & Daley, G. Q. (2009) · Nature · doi:10.1038/nature08099 · Cited by 1,129 · cited 3×
“However, since adipocytes maintain the most primitive hematopoietic stem cell, recovery of a normal BM cellularity is possible [17, 91].”
BackgroundDAMPening Inflammation by Modulating TLR Signalling
Piccinini, A. M., & Midwood, K. S. (2010) · Mediators of Inflammation · doi:10.1155/2010/672395 · Cited by 973
PPAR-γ regulates osteoclastogenesis in mice
Wan, Y., Chong, L.-W., & Evans, R. M. (2007) · Nature Medicine · doi:10.1038/nm1672 · Cited by 517
Gimble, J. M., Zvonic, S., Floyd, Z. E., Kassem, M., & Nuttall, M. E. (2006) · Journal of Cellular Biochemistry · doi:10.1002/jcb.20777 · Cited by 495
Jensen, T. S., Karppinen, J., Sorensen, J. S., Niinimäki, J., & Leboeuf-Yde, C. (2008) · European Spine Journal · doi:10.1007/s00586-008-0770-2 · Cited by 470
Self-citationTLR-dependent T cell activation in autoimmunity
Mills, K. H. G. (2011) · Nature Reviews Immunology · doi:10.1038/nri3095 · Cited by 443
Felson, D. T., Niu, J., Guermazi, A., Roemer, F., Aliabadi, P., Clancy, M., Torner, J., Lewis, C. E., & Nevitt, M. C. (2007) · Arthritis & Rheumatism · doi:10.1002/art.22851 · Cited by 432
Cited by
What low back pain is and why we need to pay attention
Hartvigsen, J., Hancock, M. J., Kongsted, A., Louw, Q., Ferreira, M. L., Genevay, S., Hoy, D., Karppinen, J., Pransky, G., Sieper, J., et al. (2018) · The Lancet · doi:10.1016/s0140-6736(18)30480-x · Cited by 4,652
Self-citationVlaeyen, J. W. S., Maher, C. G., Wiech, K., Van Zundert, J., Meloto, C. B., Diatchenko, L., Battié, M. C., Goossens, M., Koes, B., & Linton, S. J. (2018) · Nature Reviews Disease Primers · doi:10.1038/s41572-018-0052-1 · Cited by 497
A new immunometabolic perspective of intervertebral disc degeneration
Francisco, V., Pino, J., González-Gay, M. Á., Lago, F., Karppinen, J., Tervonen, O., Mobasheri, A., & Gualillo, O. (2022) · Nature Reviews Rheumatology · doi:10.1038/s41584-021-00713-z · Cited by 462
Self-citationXue, P., Wang, S., Lyu, X., Wan, M., Li, X., Ma, L., Ford, N. C., Li, Y., Guan, Y., Ding, W., et al. (2021) · Bone Research · doi:10.1038/s41413-021-00155-z · Cited by 64
Metadata
- Authors
- Dudli, S., Fields, A. J., Samartzis, D., Karppinen, J., & Lotz, J. C.
- Venue
- European Spine Journal
- Published
- 2016-02-25
- Volume
- 25
- Issue
- 11
- Pages
- 3723-3734
- ISSN
- 0940-6719 (ISSN-L)
- 1432-0932
- OpenAlex
- W2290008885
- Cited by
- 386
- References
- 64
- FWCI
- 18.50
- Type
- journal article
- Language
- en
- Open access
- green
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
How to cite
Cite CoChat for the checks on this page, and the paper for its own findings.
- This page
- CoChat. (2026). Citation check: Pathobiology of Modic changes. https://app.cochat.ai/papers/10.1007/s00586-016-4459-7
- The paper
- Dudli, S., Fields, A. J., Samartzis, D., Karppinen, J., & Lotz, J. C. (2016). Pathobiology of Modic changes. European Spine Journal. https://doi.org/10.1007/s00586-016-4459-7
Data sources
Bibliographic data: Semantic Scholar, OpenAlex, Crossref.
Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.
