Characteristics of Modic changes in cervical kyphosis and their association with axial neck pain

Abstract

Background

The purpose of this study was to evaluate characteristics of Modic changes in cervical kyphosis (CK) and their association with axial neck pain.

Methods

Study participants included 286 asymptomatic or symptomatic patients with CK (mean age = 54.2 ± 12.2 years) who were consecutively enrolled from March 2009 to October 2015. Clinical and radiographic evaluations were performed at a university outpatient department. CK was classified as global type, reverse sigmoid type, or sigmoid type.

Results

There were 138 participants with global type CK, 103 with reverse sigmoid type CK, and 45 with sigmoid type CK. Of the 286 participants, 102 had Modic changes (Modic-1 in 38 segments and Modic-2 in 75 segments). Spinal cord compression grade and disc degeneration occurred more frequently in the group with axial neck pain compared to the group without pain. Angular motion was decreased in those with axial neck pain (mean ± standard deviation [SD] 7.8°±4.6°) compared to those who were asymptomatic (mean ± SD 8.9°±5.1°; P<0.001). In multivariate logistic regression analysis, Modic changes were associated with axial neck pain (odds ratio =5.356; 95% confidence interval =1.314–12.800; P<0.001).

Conclusion

Modic changes occur most commonly in association with CK global type and less commonly with reverse sigmoid type and sigmoid type. Modic changes are associated with axial neck pain in patients with CK.

Keywords:

• cervical kyphosis
• axial neck pain
• Modic change
• kinematic analysis
• magnetic resonance imaging

Author contributions

All authors contributed toward data analysis, drafting and critically revising the paper, gave final approval of the version to be published, and agree to be accountable for all aspects of the work.

Disclosure

The authors report no conflicts of interest in this work.