Prevalence of and risk factors for Modic change in patients with symptomatic cervical spondylosis: an observational study

Background The aim of this study was to assess the prevalence of cervical Modic change (MC) in patients with cervical spondylosis and to develop a better understanding of the possible risk factors for the prevalence of MC. Methods Between January 2014 and April 2017, patients with cervical spondylosis were included in our study. All patients underwent magnetic resonance imaging (MRI) to evaluate the presence of MC. The MC was classified into three types according to the Modic classification. Potential risk factors were collected from demographic data, lifestyle variables, laboratory tests, and radiographic images. Both univariate and multivariate analysis were used to detect factors associated with MC. We further compared several variables related to fat metabolism between patients with Type 1 and Type 2 MC. Results The prevalence of MC in patients with cervical spondylosis was 9.24%. The MC was most frequent at C5-6, followed by C6-7, C4-5, and C3-4. The proportion of Type 1 MC in patients with neck pain was significantly higher than that in patients without neck pain (46.2% vs 13.6%, P=0.027). However, none of the variables associated with fat metabolism showed a significant difference between Type 1 and Type 2 MC. Multivariate logistic analysis showed that age ≥55 years (odds ratio [OR], 1.91; 95% confidence interval [CI], 1.22-2.98) and body mass index (BMI) ≥25 kg/m2 (OR, 2.41; 95% CI, 1.62-3.59) were two significant independent factors that are associated with cervical MC in patients with cervical spondylosis (P<0.05). Conclusion It appears that advanced age and high BMI were two factors that may be responsible for cervical MC. Type 1 MC is associated with the prevalence of neck pain. However, we cannot confirm that Type 2 MC is correlated with fat metabolism.