Relationship of Modic changes in endplates of cervical vertebral body with axial pain

Objective:To investigate the prevalence and clinical significance of Modic changes in endplates of cervical vertebral body in patients with cervical spondylotic myelopathy(CSM).Methods: The T1-weight and T2-weight sagittal MRI scans of 136 CSM patients undergoing anterior operation were retrospectively reviewed. The patients’ age, gender, prevalence, precise vertebral levels and specific type of Modic changes were recorded, and the association of axial pain with Modic changes was analyzed.Results: Modic changes were observed in 23 patients (16.9%), including 17(17.7%) male and 6(15%) female. The most frequent cervical spinal levels of Modic changes was C5-6. Of all the patients, 4.4% had type Ⅰ Modic change, 7.4% had type Ⅱ, and 5.1% had type Ⅲ. The incidence of axial pain was 56.5% in Modic change groups and 20.4% in non-Modic change groups; there was significant difference between the two groups (P0.05). Postoperatively, the axial pain was relieved in 76.9% in Modic change groups and 73.9% in non-Modic change groups (P0.05). The pre-operation incidences of axial pain in patients with type Ⅰ, type Ⅱ and type Ⅲ Modic change were 83.3%, 60% and 28.6%, respectively; and the post-operation pain-relieving rates were 100%, 66.7% and 50%, respectively.Conclusion: The most common Modic change is type Ⅱ in the cervical spine, with the C5-6 level being the most frequently involved. The incidence of axial pain is high in patients with Modic change, especially those with type Ⅰ.