Are Modic Vertebral End-Plate Signal Changes Associated with Degeneration or Clinical Outcomes in the Cervical Spine?

Abstract

To report on the incidence of Modic changes (MCs) in patients with cervical radiculopathy due to a herniated disc. Presence of MCs was correlated to clinical outcomes and the presence of radiological degeneration. Patients that underwent anterior discectomy for a cervical radiculopathy due to a herniating disc were analyzed for the presence of MCs at baseline and at 1-year follow-up after surgery. Neck Disability Index, physical component summary, mental component summary, and visual analog scale for neck pain and for arm pain were evaluated as clinical outcomes. The presence of radiological degeneration was defined by the method of Goffin. The prevalence of MCs was found at 18% at baseline and increased to 28% one year after surgery. Both at baseline and at 1-year follow-up, the percentage of patients with and without MCs reporting neck pain was comparable. Likewise, both at baseline and at 1-year follow-up, the percentage of patients with and without MCs reporting disabling arm pain was comparable. At baseline, the patients with MC demonstrated more radiologic degeneration than those without MC (OR 0.42), but this difference disappeared at 1 year after surgery. MCs were not associated with neck pain, nor with arm pain. Furthermore, there was a tendency for a correlation between the presence of MCs and radiological degeneration.