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Modic changes were classified into none, Type 1, Type 2, or Type 3 as described previously.7, 8?and?19 Our previous study found good intra- and inter-observer reliability of the Modic change ratings (kappa scores; 0.64 and 0.62, respectively).20 Statistical analyses were conducted using the chi-squared test for categorical data. For the analyses of association between Modic changes observed in the whiplash injury patients at follow-up and any potentially related factors were evaluated using a chi-squared test first, and factors with a p value less than 0.1 were further Arginase tested by logistic regression analysis. Candidate factors included age at the previous study (40 years), gender, regular participation in sports, smoking, occupation (light or no labour; heavy labour), and body mass index (BMI) (>25%; and BAY 73-4506 mw and disc space narrowing. We also evaluated accident details recorded during the whiplash patients�� initial interviews, such as the vehicle collision point(s), seat location, the extent of damage to the vehicle, and whether the patient was wearing a seatbelt. A p-value less than 0.05 was considered significant. In the present study, all statistical analyses were performed using IBM SPSS Statistics 20 for Windows (IBM Japan Inc., Tokyo). In the initial study, Modic changes were observed in four patients (3%) and at 7 intervertebral levels. At the follow-up study, Modic changes were observed in 17 patients (12.8%) and at 30 intervertebral levels. C5�C6 and C6�C7 were the levels most frequently involved (Table 1). Type 2 Modic changes were the most prevalent type, in both the initial and follow-up studies (Fig. 1). All of the Modic changes observed at the follow-up were newly developed; the Modic Type 1 changes observed at two intervertebral levels and the Modic Type 2 changes observed at five intervertebral levels at the initial study had disappeared LY2157299 manufacturer at the final follow-up (Table 2). There was no significant difference between the whiplash and control groups in the percentage of subjects with positive Modic changes at either the initial (3.0% vs. 4.5%, p?=?0.49, chi-square test) or the follow-up study (12.8% vs. 13.9%, p?=?0.77) ( Table 3). The details of Modic changes in the control group was reported previously.20 At the initial investigation, 125 (94%) of the whiplash injury patients had neck pain, 51 (38.4%) had headaches, 86 (64.7%) had shoulder stiffness, and 19 (14.3%) had arm pain or numbness. At the follow-up, 34 (25.6%) had neck pain, 37 (27.8%) had headaches, 73 (54.