title: The evolution of degenerative marrow (Modic) changes in the cervical spine in neck pain patients.
abstract: OBJECTIVE
  To evaluate the natural course of end plate marrow (Modic) changes (MC) in the cervical spine on MRI scans of patients with neck pain. A few longitudinal studies have assessed the development of MC over time in the lumbar spine but only two recent studies evaluated MC in the cervical spine in asymptomatic volunteers and those with whiplash. Thus, this study now reports on the natural course of MC in the cervical spine in symptomatic patients.
  
  
  METHODS
  From the cervical MRI scans of 426 neck pain patients (mean age 61.2 years), 64 patients had follow-up MRI studies. The prevalence and types of MC were retrospectively assessed on the follow-up scans and compared to the original MRI findings.
  
  
  RESULTS
  With an average of 2.5 years between the two MRI scans, the prevalence of MC type 1 (MC1) noted at baseline (7.4% or 19 motion segments) slightly increased (8.2% or 21 segments) but the prevalence of MC2 (14.5% or 37 segments) increased considerably (22.3% or 57 segments). In addition, 14 new MC1 segments and 8 new MC2 segments were noted. Twelve segments with MC1 at baseline converted to MC2 at follow-up. No conversion from MC2 to MC1 or reverting to a normal image was observed.
  
  
  CONCLUSIONS
  MC in the cervical spine are a dynamic phenomenon similar to the lumbar spine.
authors.affiliation: Radiology Department, Orthopaedic University Hospital Balgrist, Forchstr. 340, 8008, Zürich, Switzerland, eugenmn@hotmail.com.
authors.forename: Eugen
authors.initials: E
authors.lastname: Mann
authors.forename: Cynthia K
authors.initials: CK
authors.lastname: Peterson
authors.forename: Jürg
authors.initials: J
authors.lastname: Hodler
authors.forename: Christian W A
authors.initials: CW
authors.lastname: Pfirrmann
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001853:Bone Marrow / Q000473:pathology*; D002574:Cervical Vertebrae / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008159:Lumbar Vertebrae / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019547:Neck Pain / Q000209:etiology*; D015995:Prevalence; D012189:Retrospective Studies