STUDY DESIGN: Observational cohort study. OBJECTIVE: To assess the association of Modic changes and DEBC classification in patients with cervical degenerative disc disease. METHODS: The study includes 2 groups, neck pain patients presenting to the out-patient services (neck pain group) (n = 301) and polytrauma patients without cervical spine injury or a history of neck pain, who underwent whole spine MRI (control group) (n = 200). Degenerative changes in the MRI were classified according to the Modic changes (MC) and DEBC classification. Modifiers including End-Plate (EP) erosion and herniation (H+) presence were documented. RESULTS: 3612 EPs of 301 patients with neck pain and 2400 EPs of 200 controls were assessed. The incidence of MC and DEBC in the neck pain group was 20.93% and in the control group, it was 12%, ( CONCLUSION: Our study highlights that patients with DEBC changes and disc herniation were more likely to experience neck pain and require surgical intervention, indicating the reliability and clinical significance of the DEBC classification in degenerative cervical spine patients.