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DOI: 10.1148/radiol.2451051706
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(Radiology 2007;245:43-61.)
© RSNA, 2007

Reviews

Lumbar Degenerative Disk Disease1

Michael T. Modic, MD and Jeffrey S. Ross, MD

1 From the Division of Radiology, Cleveland Clinic Foundation, 9500 Euclid Ave, Cleveland, OH 44195. Received October 31, 2005; revision requested December 1; revision received February 15, 2006; accepted March 10; final version accepted June 8; final review and update by M.T.M. March 28. Address correspondence to M.T.M. (e-mail: modicm1{at}ccf.org).

The sequelae of disk degeneration are among the leading causes of functional incapacity in both sexes and are a common source of chronic disability in the working years. Disk degeneration involves structural disruption and cell-mediated changes in composition. Mechanical, traumatic, nutritional, and genetic factors all may play a role in the cascade of disk degeneration, albeit to variable degree in different individuals. The presence of degenerative change is by no means an indicator of symptoms, and there is a very high prevalence in asymptomatic individuals. The etiology of pain as the symptom of degenerative disease is complex and appears to be a combination of mechanical deformation and the presence of inflammatory mediators. The role of imaging is to provide accurate morphologic information and influence therapeutic decision making. A necessary component, which connects these two purposes, is accurate natural history data. Understanding the relationship of etiologic factors, the morphologic alterations, which can be characterized with imaging, and the mechanisms of pain production and their interactions in the production of symptoms will require more accurate and reproducible stratification of patient cohorts.

© RSNA, 2007




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K. J. Thompson, A. P. Dagher, T. S. Eckel, M. Clark, and J. W. Reinig
Modic Changes on MR Images as Studied with Provocative Diskography: Clinical Relevance--A Retrospective Study of 2457 Disks
Radiology, March 1, 2009; 250(3): 849 - 855.
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