• Zhi-Jun Hu, Feng-Dong Zhao, Xiang-Qian Fang, and Shun-Wu Fan.
• Department of Orthopaedics, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, China.
• Med. Hypotheses. 2009 Dec 1;73(6):930-2.

UnlabelledModic changes are bone marrow and endplate lesions visible in magnetic resonance imaging (MRI). They are regarded as a part of degenerative disc disease and associated with low back pain. And severe disc degeneration was occurred more in the patients with Modic changes. But there is still no study to analyze the relationship between Modic changes and intervertebral disc degeneration. We hypothesize that Modic changes are the possible causes and promotion of lumbar intervertebral disc degeneration. And there are three possible mechanisms for this hypothesis: a structural cause: Modic changes make cartilaginous material easier in extruded disc herniations, to destroy the structure of intervertebral disc and inhibit the absorption of the disc. A biomechanical cause: Modic changes alter the mechanical loading distribution on disc, to initiate a series of disc disruption and inhibit the self-recovery of the disc. A nutritional cause: Modic changes destroy the vascular architecture in vertebral endplate and block the most important metabolism pathway between vertebrae and disc.Perspectives(1) Find out procedures to cure Modic changes may be an important breakthrough for disc degenerative disease. (2) Treatment of Modic changes may be a critical step of biotherapy for disc degeneration disease.

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