Relation Between Neck Pain and Modic Changes in Cervical Spondylotic Myelopathy

BACKGROUND Modic changes on magnetic resonance imaging (MRI) represent lesions in the bone marrow of the vertebral body that may be associated with pain. This study investigated the relationship between neck pain and cervical Modic changes, and risk factors for neck pain (NP). MATERIAL AND METHODS This study included 168 patients diagnosed with cervical spondylotic myelopathy between February 2013 and April 2017. Basic patient information about demographic and lifestyle variables was obtained from medical records. Radiographic images provided cervical alignment (C2-C7 Cobb), T1 slope and C7 slope. All patients underwent MRI to evaluate the presence of Modic changes. Univariate analyses identified the variables as potential factors. Variables with a p<0.10 were included in the multivariate logistic regression analysis models. P-values <0.05 were statistically significant. RESULTS Only 93 patients (55.4%) had NP. Modic changes in patients with NP were significantly higher than those without Modic changes (p=0.002). Eighty-five patients had Modic changes types I, II, III; 41 (48.2%), 29 (34.1%), 15 (17.6%), respectively. The distribution of these Modic changes varied with NP (p<0.001). Type I Modic changes were seen with NP more frequently than other types of Modic changes. Univariate and multivariate analyses showed that age (odds ratio [OR], 1.09; 95% confidence interval [CI], 1.02-1.16) and Modic changes (OR 1.25; 95% CI, 0.09-1.46) were significant independent factors for NP. CONCLUSIONS In cervical spondylosis, age and Modic changes were associated with NP. Modic change type I is more likely to occur with NP.