Modic changes in the cervical spine: Prospective 20-year follow-up study in asymptomatic subjects |
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| Affiliation: | 1. Department of Orthopaedic Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, 160-8582, Japan;2. Department of Orthopaedic Surgery, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan;3. Department of Diagnostic Radiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, 160-8582, Japan;4. Department of Environmental and Occupational Health, Department of Social Medicine, Faculty of Medicine, Toho University, 5-21-16 Ohmorinishi, Ohta, Tokyo, 143-8540, Japan;5. Department of Orthopaedic Surgery, Isehara Kyodo Hospital, 345 Tanaka, Isehara, Kanagawa, 259-1187, Japan;6. Department of Orthopaedic Surgery, Surgical Science, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1193, Japan;7. Department of Orthopaedic Surgery, Spine Center, Sanokousei General Hospital, 1728 Horigome, Sano, Tochigi, 327-8511, Japan;1. Department of Orthopaedic Surgery, Faculty of Medicine, University of Toyama, Toyama, 930-0194, Japan;2. Department of Orthopaedic Surgery, Takaoka City Hospital, Toyama, 933-8550, Japan;3. Department of Orthopaedic Surgery, Toyama Rosai Hospital, 662 Rokuromaru, Uozu, Toyama, 937-0042, Japan;4. Department of Orthopedic Surgery, Niigata University Medicine and Dental General Hospital, 1–754 Asahimachidori, Chuo Ward, Niigata, 951–8520 Japan;5. Department of Orthopaedic Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan;1. Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan;2. Department of Orthopaedic Surgery, Japanese Red Cross Nagoya Daini Hospital, Nagoya, Japan;3. Department of Rehabilitation, Kansai University of Welfare Science, Osaka, Japan;1. Ishii Orthopaedic & Rehabilitation Clinic, 1089 Shimo-Oshi, Gyoda, Saitama, 361-0037, Japan;2. Kouseiren Takaoka Hospital, 5-10 Eirakutyo Takaoka, Toyama, 933-8555, Japan;3. Niigata University Crisis Management Office, Niigata University Hospital, Niigata University Graduate School of Medical and Dental Sciences, 1 Asahimachi Dori Niigata, Niigata, 951-8520, Japan;1. Department of Orthopaedic Surgery, Izumi City General Hospital, 4-5-1, Wakecho, Izumi City, Osaka, 594-0071, Japan;2. Department of Orthopaedic Surgery, Osaka City General Hospital, 2-13-22 Miyakojimahondori Miyakojima, Osaka City, Osaka, 534-0021, Japan |
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| Abstract: | BackgroundFew studies have characterized the development of Modic changes in the cervical spine over time. We evaluated Modic changes of the cervical spine that developed over a 20-year period in a healthy cohort, and sought to clarify the relationship between Modic changes and the development of clinical symptoms.MethodsFor this multicenter prospective cohort study, we recruited 193 subjects from an original cohort of asymptomatic volunteers who underwent MRI of the cervical spine between 1993 and 1996. Each cervical level from C2/3 to C7/T1 (total n = 1158 intervertebral levels) was assessed on current MRIs as normal or showing type 1, 2, or 3 Modic change, and we asked about symptoms related to the cervical spine. Relationships between the presence of Modic changes and patient characteristics, pre-existing disc degenerations or clinical symptoms were evaluated by logistic regression analysis.ResultsAfter 20-year follow-up, Modic changes affected 31 subjects (16.1%) at 47 intervertebral disc levels. Of these 47 intervertebral disc levels, type 2, found at 30 levels (63.8%), was the most frequent, followed by type 1 at 15 levels (31.9%) and type 3 at two levels (4.3%). The most frequent changes were observed at the C5/6 segment with type 2 Modic changes. The presence of Modic changes correlated with pre-existing posterior disc protrusion (odds ratio 3.31, 95% confidence interval 1.21–9.05) and neck pain (odds ratio 2.71, 95% confidence interval 1.08–6.80).ConclusionsIn the cervical spine over a 20-year period, type 2 Modic changes were most frequent at the C5/6 segment. The Modic changes were associated with pre-existing disc degeneration and neck pain but not with age, BMI, smoking, shoulder stiffness, arm pain or numbness. |
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