XXXX (modic) changes on cervical spine magnetic resonance imaging scans: prevalence, inter- and intra-examiner reliability and link to disc herniation.

@entity1 @entity236 @entity23633 @entity158
STUDY DESIGN: A prevalence and reliability study of Modic changes (MCs) in the cervical spine. OBJECTIVE: To assess the prevalence and reliability of diagnosing and classifying MCs and their relationship to disc herniations (DHs) in the cervical spine. SUMMARY OF BACKGROUND DATA: @entity236 (Modic) changes in the spine can be seen on MRI with some evidence linking them to @entity158 . Many studies have been published on MCs in the lumbar spine, but only one small prevalence study focusing on MCs in the cervical spine has been reported. METHODS: The cervical magnetic resonance imaging (MRI) scans of 500 @entity1 over the age of 50 were retrospectively evaluated for the prevalence, type, and location of MCs and DHs. Two hundred of these same scans were independently analyzed by a second observer to evaluate interobserver reliability of diagnosis with 100 re-evaluated by the same observer 1 month later to assess intraobserver reliability. The SPSS program and Kappa statistics were used to assess prevalence and reliability. The risk ratio comparison of DH and MC was calculated. RESULTS: Four hundred and twenty-six @entity1 (85.2%) met the inclusion criteria. MCs were observed in 40.4% of @entity1 (14.4% of all motion segments). A 4.3% were type 1 and 10.1% were type 2. DH were seen in 78.2% of @entity1 (13.3% of motion segments). Both MC and DH were most frequently observed at @entity23633 . Disc extrusions were positively associated with MC (RR=2.4). The reliability showed an upper moderate interobserver (k=0.54) and an almost perfect intraobserver agreement (k=0.82). CONCLUSION: A high prevalence of MCs was observed with type 2 predominating. The @entity23633 levels are most effected. @entity1 with MC are more likely to have a DH at the same level. MC type 2 predominates. The classification is reliable.
