title: Modic changes of the cervical spine in patients with whiplash injury: a prospective 11-year follow-up study.
abstract: BACKGROUND
  There are few studies on Modic changes of the cervical spine in patients suffering from whiplash. This study compared Modic changes seen in whiplash patients 10 years after the injury with those observed in asymptomatic volunteers.
  
  
  METHODS
  This is a follow-up study of 133 patients who suffered whiplash injuries in 1994-1996 and underwent MRI with a superconductive imager (63 men, 70 women, mean age 49.6±15.3 years, mean follow-up 11.4 years). In addition, 223 healthy volunteers who underwent MRI during the same period were included as controls (123 men, 100 women, mean age 50.5±15.0 years, mean follow-up 11.6 years). All participants underwent follow-up MRI. We examined all participants for Modic changes, and investigated relationships between Modic changes and clinical symptoms or potentially related factors.
  
  
  RESULTS
  Modic changes were observed in 4 patients (3%) and at 7 intervertebral levels in the initial study, and in 17 patients (12.8%) and at 30 intervertebral levels at the follow-up. Modic Type 2 changes were the most prevalent in the whiplash patients in both the initial and follow-up studies. There was no significant difference in the percentage of whiplash patients versus control subjects with positive Modic changes, either at the initial study or at follow-up. Modic changes were not related to clinical symptoms present at follow-up, but were associated with preexisting disc degeneration. There was no association between Modic changes and the details of the car accident that caused the injury.
  
  
  CONCLUSIONS
  While Modic changes became more common in whiplash patients in the 10-year period after the accident, they occurred with a similar frequency in control subjects. We did not find any association between Modic changes and the nature of the car accident in which the whiplash occurred. Modic changes found in whiplash patients may be a result of the physiological ageing process rather than pathological findings relating to the whiplash injury.
authors.affiliation: Department of Orthopaedic Surgery, Keio University, Japan. morio@a5.keio.jp
authors.forename: Morio
authors.initials: M
authors.lastname: Matsumoto
authors.forename: Daisuke
authors.initials: D
authors.lastname: Ichihara
authors.forename: Eijiro
authors.initials: E
authors.lastname: Okada
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Toyama
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Fujiwara
authors.forename: Suketaka
authors.initials: S
authors.lastname: Momoshima
authors.forename: Yuji
authors.initials: Y
authors.lastname: Nishiwaki
authors.forename: Takeshi
authors.initials: T
authors.lastname: Takahata
mesh_terms: D000328:Adult; D000368:Aged; D000375:Aging / Q000473:pathology*; D035881:Compensation and Redress; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D055959:Intervertebral Disc Degeneration / Q000453:epidemiology / Q000473:pathology*; D007564:Japan / Q000453:epidemiology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019547:Neck Pain / Q000191:economics / Q000453:epidemiology / Q000473:pathology*; D064266:Preexisting Condition Coverage / Q000706:statistics & numerical data*; D015995:Prevalence; D011446:Prospective Studies; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires; D013997:Time Factors; D015599:Trauma Severity Indices; D014911:Whiplash Injuries / Q000191:economics / Q000453:epidemiology / Q000473:pathology*