Modic changes in the cervical spine

Prospective 20-year follow-up study in asymptomatic subjects

Takashi Tsuji, Hirokazu Fujiwara, Yuji Nishiwaki, Kenshi Daimon, Eijiro Okada, Kenya Nojiri, Masahiko Watanabe, Hiroyuki Katoh, Kentaro Shimizu, Hiroko Ishihama, Nobuyuki Fujita, Masaya Nakamura, Morio Matsumoto, Kota Watanabe

Research output: Contribution to journalArticle

Abstract

Background: Few 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. Methods: For 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. Results: After 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). Conclusions: In 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.

Original languageEnglish
Pages (from-to)612-617
Number of pages6
JournalJournal of Orthopaedic Science
Volume24
Issue number4
DOIs
Publication statusPublished - 01-07-2019

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Spine
Intervertebral Disc Degeneration
Neck Pain
Intervertebral Disc
Odds Ratio
Confidence Intervals
Hypesthesia
Volunteers
Arm
Cohort Studies
Logistic Models
Smoking
Regression Analysis
Prospective Studies
Pain

All Science Journal Classification (ASJC) codes

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Tsuji, Takashi ; Fujiwara, Hirokazu ; Nishiwaki, Yuji ; Daimon, Kenshi ; Okada, Eijiro ; Nojiri, Kenya ; Watanabe, Masahiko ; Katoh, Hiroyuki ; Shimizu, Kentaro ; Ishihama, Hiroko ; Fujita, Nobuyuki ; Nakamura, Masaya ; Matsumoto, Morio ; Watanabe, Kota. / Modic changes in the cervical spine : Prospective 20-year follow-up study in asymptomatic subjects. In: Journal of Orthopaedic Science. 2019 ; Vol. 24, No. 4. pp. 612-617.
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abstract = "Background: Few 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. Methods: For 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. Results: After 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). Conclusions: In 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.",
author = "Takashi Tsuji and Hirokazu Fujiwara and Yuji Nishiwaki and Kenshi Daimon and Eijiro Okada and Kenya Nojiri and Masahiko Watanabe and Hiroyuki Katoh and Kentaro Shimizu and Hiroko Ishihama and Nobuyuki Fujita and Masaya Nakamura and Morio Matsumoto and Kota Watanabe",
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Tsuji, T, Fujiwara, H, Nishiwaki, Y, Daimon, K, Okada, E, Nojiri, K, Watanabe, M, Katoh, H, Shimizu, K, Ishihama, H, Fujita, N, Nakamura, M, Matsumoto, M & Watanabe, K 2019, 'Modic changes in the cervical spine: Prospective 20-year follow-up study in asymptomatic subjects', Journal of Orthopaedic Science, vol. 24, no. 4, pp. 612-617. https://doi.org/10.1016/j.jos.2018.12.015

Modic changes in the cervical spine : Prospective 20-year follow-up study in asymptomatic subjects. / Tsuji, Takashi; Fujiwara, Hirokazu; Nishiwaki, Yuji; Daimon, Kenshi; Okada, Eijiro; Nojiri, Kenya; Watanabe, Masahiko; Katoh, Hiroyuki; Shimizu, Kentaro; Ishihama, Hiroko; Fujita, Nobuyuki; Nakamura, Masaya; Matsumoto, Morio; Watanabe, Kota.

In: Journal of Orthopaedic Science, Vol. 24, No. 4, 01.07.2019, p. 612-617.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Modic changes in the cervical spine

T2 - Prospective 20-year follow-up study in asymptomatic subjects

AU - Tsuji, Takashi

AU - Fujiwara, Hirokazu

AU - Nishiwaki, Yuji

AU - Daimon, Kenshi

AU - Okada, Eijiro

AU - Nojiri, Kenya

AU - Watanabe, Masahiko

AU - Katoh, Hiroyuki

AU - Shimizu, Kentaro

AU - Ishihama, Hiroko

AU - Fujita, Nobuyuki

AU - Nakamura, Masaya

AU - Matsumoto, Morio

AU - Watanabe, Kota

PY - 2019/7/1

Y1 - 2019/7/1

N2 - Background: Few 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. Methods: For 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. Results: After 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). Conclusions: In 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.

AB - Background: Few 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. Methods: For 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. Results: After 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). Conclusions: In 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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U2 - 10.1016/j.jos.2018.12.015

DO - 10.1016/j.jos.2018.12.015

M3 - Article

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EP - 617

JO - Journal of Orthopaedic Science

JF - Journal of Orthopaedic Science

SN - 0949-2658

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