INTRODUCTION: Modic changes (MC) are vertebral bone marrow changes adjacent to the endplates as noted on MRI. The association of specific MC type with low back pain (LBP) remains inconclusive, largely attributed to small sample sizes with limited phenotype assessment. Recently, the MC phenotype has been thoroughly defined. In relation to disabling LBP, various aspects of the topography and morphology of MC have not been properly assessed. As such, this study evaluated the relationship of disabling LBP with lumbar MC based on an extensive ...postprin