Preoperative Modic Changes Are Related to Axial Symptoms After Anterior Cervical Discectomy and Fusion

Overview

Journal J Pain Res

Publisher Dove Medical Press

Date 2018 Nov 23

PMID 30464580

Citations 9

Authors

Jiaming Zhou

Liandong Li

Tengshuai Li

Yuan Xue

Affiliations

Soon will be listed here.

Abstract

Background: The objective of this study was to compare the clinical and radiological outcomes between patients with or without axial symptoms (AS) and investigate the risk factors associated with AS by multivariate regression analysis in anterior cervical discectomy and fusion (ACDF).

Materials And Methods: The records of 117 patients who underwent ACDF were reviewed for clinical and radiological outcomes. These outcomes were evaluated before and after surgery and at the last follow-up. Preoperative Modic changes (MCs) adjacent to the treated disc were identified. Risk factors for AS were detected through logistic regression analysis.

Results: The patients were divided into two groups: one with AS (AS group, n=35) and the other without (NAS group, n=82). Visual Analog Scale values after the operation (=0.013) and at final follow-up (<0.001) and preoperative segmental angle (=0.031) were significantly different between the two groups. There were no significant differences with respect to other clinical and radiographic outcomes between the two groups (>0.05). Logistic regression analysis revealed that preoperative segmental kyphosis (OR =2.912, =0.035) and MCs (odds ratio =3.268, =0.015) were the risk factors for the occurrence of AS.

Conclusion: AS do not correlate with recovery of neural function in patients treated by ACDF. In addition, preoperative segmental kyphosis and MCs at the fusion segment were found to affect the incidence of AS after ACDF.

Citing Articles

Development and validation of a predictive model for the risk of symptomatic adjacent segmental degeneration after anterior cervical discectomy and fusion.

Liang X, Ran L, Zhang Z, Xiao X, Wang C, Du Y Front Neurol. 2025; 16:1530257.

PMID: 40035035 PMC: 11873071. DOI: 10.3389/fneur.2025.1530257.

Correlation between axial symptoms and cervical sagittal alignment parameters in patients with two-level or three-level cervical spondylotic myelopathy: anterior cervcial discectomy and fusion versus hybird surgery.

Qiu Z, Xiong Y, Yu X, Li W, Ma Y, Feng N Eur Spine J. 2024; 33(8):3017-3026.

PMID: 38795150 DOI: 10.1007/s00586-024-08316-4.

Cervical alignment and clinical outcome of anterior cervical discectomy and fusion vs. anterior cervical corpectomy and fusion in local kyphotic cervical spondylotic myelopathy.

Du W, Wang H, Lv J, Wang S, Shen Y, Zhang X Heliyon. 2023; 9(8):e19106.

PMID: 37636480 PMC: 10450976. DOI: 10.1016/j.heliyon.2023.e19106.

Cervical alignment and clinical outcome of anterior decompression with fusion vs. posterior decompression with fixation in kyphotic cervical spondylotic myelopathy.

Du W, Wang H, Zhang J, Wang F, Zhang X, Shen Y Front Neurosci. 2022; 16:1029327.

PMID: 36507328 PMC: 9728799. DOI: 10.3389/fnins.2022.1029327.

Evaluating the Impact of Modic Changes on Operative Treatment in the Cervical and Lumbar Spine: A Systematic Review and Meta-Analysis.

Lambrechts M, Brush P, Issa T, Toci G, Heard J, Syal A Int J Environ Res Public Health. 2022; 19(16).

PMID: 36011795 PMC: 9408205. DOI: 10.3390/ijerph191610158.

References

Chung C, Vande Berg B, Tavernier T, Cotten A, Laredo J, Vallee C . End plate marrow changes in the asymptomatic lumbosacral spine: frequency, distribution and correlation with age and degenerative changes. Skeletal Radiol. 2004; 33(7):399-404. DOI: 10.1007/s00256-004-0780-z. View

Jensen T, Karppinen J, Sorensen J, Niinimaki J, Leboeuf-Yde C . Vertebral endplate signal changes (Modic change): a systematic literature review of prevalence and association with non-specific low back pain. Eur Spine J. 2008; 17(11):1407-22. PMC: 2583186. DOI: 10.1007/s00586-008-0770-2. View

Albert H, Briggs A, Kent P, Byrhagen A, Hansen C, Kjaergaard K . The prevalence of MRI-defined spinal pathoanatomies and their association with modic changes in individuals seeking care for low back pain. Eur Spine J. 2011; 20(8):1355-62. PMC: 3175840. DOI: 10.1007/s00586-011-1794-6. View

Kalsi-Ryan S, Karadimas S, Fehlings M . Cervical spondylotic myelopathy: the clinical phenomenon and the current pathobiology of an increasingly prevalent and devastating disorder. Neuroscientist. 2012; 19(4):409-21. DOI: 10.1177/1073858412467377. View

Ohara A, Miyamoto K, Naganawa T, Matsumoto K, Shimizu K . Reliabilities of and correlations among five standard methods of assessing the sagittal alignment of the cervical spine. Spine (Phila Pa 1976). 2006; 31(22):2585-91. DOI: 10.1097/01.brs.0000240656.79060.18. View

Li J, Lei T, Shen Y . The Impact of Modic-2 changes on the clinical outcomes of single-level anterior cervical discectomy and fusion. Eur Spine J. 2015; 24(12):2936-40. DOI: 10.1007/s00586-015-4161-1. View

Kjaer P, Korsholm L, Bendix T, Sorensen J, Leboeuf-Yde C . Modic changes and their associations with clinical findings. Eur Spine J. 2006; 15(9):1312-9. PMC: 2438570. DOI: 10.1007/s00586-006-0185-x. View

Sasai K, Saito T, Akagi S, Kato I, Ogawa R . Cervical curvature after laminoplasty for spondylotic myelopathy--involvement of yellow ligament, semispinalis cervicis muscle, and nuchal ligament. J Spinal Disord. 2000; 13(1):26-30. DOI: 10.1097/00002517-200002000-00005. View

Hosono N, Yonenobu K, Ono K . Neck and shoulder pain after laminoplasty. A noticeable complication. Spine (Phila Pa 1976). 1996; 21(17):1969-73. DOI: 10.1097/00007632-199609010-00005. View

10.

Edwards 2nd C, Heller J, Murakami H . Corpectomy versus laminoplasty for multilevel cervical myelopathy: an independent matched-cohort analysis. Spine (Phila Pa 1976). 2002; 27(11):1168-75. DOI: 10.1097/00007632-200206010-00007. View

11.

Modic M, Steinberg P, Ross J, Masaryk T, Carter J . Degenerative disk disease: assessment of changes in vertebral body marrow with MR imaging. Radiology. 1988; 166(1 Pt 1):193-9. DOI: 10.1148/radiology.166.1.3336678. View

12.

Emery S, Bohlman H, Bolesta M, Jones P . Anterior cervical decompression and arthrodesis for the treatment of cervical spondylotic myelopathy. Two to seventeen-year follow-up. J Bone Joint Surg Am. 1998; 80(7):941-51. DOI: 10.2106/00004623-199807000-00002. View

13.

Ross J, Modic M . Current assessment of spinal degenerative disease with magnetic resonance imaging. Clin Orthop Relat Res. 1992; (279):68-81. View

14.

Iizuka H, Shimizu T, Tateno K, Toda N, Edakuni H, Shimada H . Extensor musculature of the cervical spine after laminoplasty: morphologic evaluation by coronal view of the magnetic resonance image. Spine (Phila Pa 1976). 2001; 26(20):2220-6. DOI: 10.1097/00007632-200110150-00013. View

15.

Sheng-yun L, Letu S, Jian C, Mamuti M, Jun-hui L, Zhi S . Comparison of modic changes in the lumbar and cervical spine, in 3167 patients with and without spinal pain. PLoS One. 2014; 9(12):e114993. PMC: 4266639. DOI: 10.1371/journal.pone.0114993. View

16.

Smith G, Robinson R . The treatment of certain cervical-spine disorders by anterior removal of the intervertebral disc and interbody fusion. J Bone Joint Surg Am. 1958; 40-A(3):607-24. View

17.

Bohlman H, Emery S, Goodfellow D, Jones P . Robinson anterior cervical discectomy and arthrodesis for cervical radiculopathy. Long-term follow-up of one hundred and twenty-two patients. J Bone Joint Surg Am. 1993; 75(9):1298-307. DOI: 10.2106/00004623-199309000-00005. View

18.

Cabraja M, Abbushi A, Koeppen D, Kroppenstedt S, Woiciechowsky C . Comparison between anterior and posterior decompression with instrumentation for cervical spondylotic myelopathy: sagittal alignment and clinical outcome. Neurosurg Focus. 2010; 28(3):E15. DOI: 10.3171/2010.1.FOCUS09253. View

19.

Kawakami M, Tamaki T, Yoshida M, Hayashi N, Ando M, Yamada H . Axial symptoms and cervical alignments after cervical anterior spinal fusion for patients with cervical myelopathy. J Spinal Disord. 1999; 12(1):50-6. View

20.

Kuisma M, Karppinen J, Niinimaki J, Ojala R, Haapea M, Heliovaara M . Modic changes in endplates of lumbar vertebral bodies: prevalence and association with low back and sciatic pain among middle-aged male workers. Spine (Phila Pa 1976). 2007; 32(10):1116-22. DOI: 10.1097/01.brs.0000261561.12944.ff. View