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The evolution of degenerative marrow (Modic) changes in the cervical spine in neck pain patients

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Abstract

Purpose

To evaluate the natural course of end plate marrow (Modic) changes (MC) in the cervical spine on MRI scans of patients with neck pain. A few longitudinal studies have assessed the development of MC over time in the lumbar spine but only two recent studies evaluated MC in the cervical spine in asymptomatic volunteers and those with whiplash. Thus, this study now reports on the natural course of MC in the cervical spine in symptomatic patients.

Methods

From the cervical MRI scans of 426 neck pain patients (mean age 61.2 years), 64 patients had follow-up MRI studies. The prevalence and types of MC were retrospectively assessed on the follow-up scans and compared to the original MRI findings.

Results

With an average of 2.5 years between the two MRI scans, the prevalence of MC type 1 (MC1) noted at baseline (7.4 % or 19 motion segments) slightly increased (8.2 % or 21 segments) but the prevalence of MC2 (14.5 % or 37 segments) increased considerably (22.3 % or 57 segments). In addition, 14 new MC1 segments and 8 new MC2 segments were noted. Twelve segments with MC1 at baseline converted to MC2 at follow-up. No conversion from MC2 to MC1 or reverting to a normal image was observed.

Conclusions

MC in the cervical spine are a dynamic phenomenon similar to the lumbar spine.

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Acknowledgments

No funds were received in support of this work. No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript. Because this was a retrospective study using data routinely collected, and because patients signed informed consent prior to their procedures, specific ethics approval for this study was not required according to a waiver issued by the ethics committee.

Conflict of interest

None.

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Authors and Affiliations

  1. Radiology Department, Orthopaedic University Hospital Balgrist, Forchstr. 340, 8008, Zürich, Switzerland

    Eugen Mann, Cynthia K. Peterson & Christian W. A. Pfirrmann

  2. Department of Radiology, University Hospital Zürich, Zürich, Switzerland

    Jürg Hodler

Authors
  1. Eugen Mann
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  2. Cynthia K. Peterson
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  3. Jürg Hodler
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  4. Christian W. A. Pfirrmann
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Correspondence to Eugen Mann.

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Mann, E., Peterson, C.K., Hodler, J. et al. The evolution of degenerative marrow (Modic) changes in the cervical spine in neck pain patients. Eur Spine J 23, 584–589 (2014). https://doi.org/10.1007/s00586-013-2882-6

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  • DOI: https://doi.org/10.1007/s00586-013-2882-6

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