Skip to main content
Top
Published in: European Spine Journal 12/2015

01-12-2015 | Original Article

The Impact of Modic-2 changes on the clinical outcomes of single-level anterior cervical discectomy and fusion

Authors: Jia Li, Tao Lei, Yong Shen

Published in: European Spine Journal | Issue 12/2015

Login to get access

Abstract

Purpose

The purpose of the study was to explore the impact of Modic-2 changes on the clinical outcomes of single-level anterior cervical discectomy and fusion.

Methods

This study retrospectively reviewed the medical records of 35 ACDF patients with Modic-2 changes at adjacent level (Group A) and 213 patients without Modic-2 changes at adjacent level (Group B). Clinical and radiographic evaluations were performed preoperatively and repeated at 3, 6, 12, and 60 months after surgery.

Result

All patients were followed up for an average of 60 months. The clinical improvements in terms of NDI and JOA scores were achieved in both groups (P < 0.05), and no significant differences were found between the two groups (P > 0.05). The radiologic review demonstrated ASD was proven in 9 patients in Group A and 52 patients in Group B. A significant increase in ROM at the adjacent segments after surgery was observed in both groups (P < 0.05). No significant differences in adjacent segment ROM and DH were observed between two groups (P > 0.05). Comparing the outcome VAS of axial symptoms with Group A after surgery, patients in the Group B reported significantly lower VAS of axial symptoms at 1-year follow-up (P < 0.05). There were no significant differences between the two groups at the final follow-up (P > 0.05).

Conclusion

Modic-2 changes at adjacent level at baseline does not affect fusion rate or clinical outcome based on functional status but could negatively impact axial symptoms intensity and ASD, compared to patients without Modic-2 changes.
Literature
1.
go back to reference Cho SK, Riew KD (2013) Adjacent segment disease following cervical spine surgery. J Am Acad Orthop Surg 21(1):3–11CrossRefPubMed Cho SK, Riew KD (2013) Adjacent segment disease following cervical spine surgery. J Am Acad Orthop Surg 21(1):3–11CrossRefPubMed
2.
go back to reference Njoku I Jr, Alimi M, Leng LZ et al (2014) Anterior cervical discectomy and fusion with a zero-profile integrated plate and spacer device: a clinical and radiological study: Clinical article. J Neurosurg Spine 21(4):529–537CrossRefPubMed Njoku I Jr, Alimi M, Leng LZ et al (2014) Anterior cervical discectomy and fusion with a zero-profile integrated plate and spacer device: a clinical and radiological study: Clinical article. J Neurosurg Spine 21(4):529–537CrossRefPubMed
3.
go back to reference Matz PG, Holly LT, Mummaneni PV et al (2009) Anterior cervical surgery for the treatment of cervical degenerative myelopathy. J Neurosurg Spine 11(2):170–173CrossRefPubMed Matz PG, Holly LT, Mummaneni PV et al (2009) Anterior cervical surgery for the treatment of cervical degenerative myelopathy. J Neurosurg Spine 11(2):170–173CrossRefPubMed
4.
go back to reference Fountas KN, Kapsalaki EZ, Nikolakakos LG, et al (2007) Anterior cervical discectomy and fusion associated complications. Spine (Phila Pa 1976) 32(21):2310–2317 Fountas KN, Kapsalaki EZ, Nikolakakos LG, et al (2007) Anterior cervical discectomy and fusion associated complications. Spine (Phila Pa 1976) 32(21):2310–2317
5.
go back to reference Li GL, Hu JZ, Lu HB et al (2015) Anterior cervical discectomy with arthroplasty versus anterior cervical discectomy and fusion for cervical spondylosis. J Clin Neurosci 22(3):460–467CrossRefPubMed Li GL, Hu JZ, Lu HB et al (2015) Anterior cervical discectomy with arthroplasty versus anterior cervical discectomy and fusion for cervical spondylosis. J Clin Neurosci 22(3):460–467CrossRefPubMed
6.
go back to reference Hilibrand AS, Robbins M (2004) Adjacent segment degeneration and adjacent segment disease: the consequences of spinal fusion? Spine J 4(6 Suppl):190S–194SCrossRefPubMed Hilibrand AS, Robbins M (2004) Adjacent segment degeneration and adjacent segment disease: the consequences of spinal fusion? Spine J 4(6 Suppl):190S–194SCrossRefPubMed
7.
go back to reference Hilibrand AS, Carlson GD, Palumbo MA et al (1999) Radiculopathy and myelopathy at segments adjacent to the site of a previous anterior cervical arthrodesis. J Bone Joint Surg Am 81(4):519–528PubMed Hilibrand AS, Carlson GD, Palumbo MA et al (1999) Radiculopathy and myelopathy at segments adjacent to the site of a previous anterior cervical arthrodesis. J Bone Joint Surg Am 81(4):519–528PubMed
8.
go back to reference Modic MT, Steinberg PM, Ross JS et al (1988) Degenerative disk disease: assessment of changes in vertebral body marrow with MR imaging. Radiology 166:193–199CrossRefPubMed Modic MT, Steinberg PM, Ross JS et al (1988) Degenerative disk disease: assessment of changes in vertebral body marrow with MR imaging. Radiology 166:193–199CrossRefPubMed
9.
go back to reference Mann E, Peterson CK, Hodler J (2011) Degenerative marrow (modic) changes on cervical spine magnetic resonance imaging scans: prevalence, inter- and intra-examiner reliability and link to disc herniation. Spine 36:1081–1085CrossRefPubMed Mann E, Peterson CK, Hodler J (2011) Degenerative marrow (modic) changes on cervical spine magnetic resonance imaging scans: prevalence, inter- and intra-examiner reliability and link to disc herniation. Spine 36:1081–1085CrossRefPubMed
10.
go back to reference Matsumoto M, Okada E, Ichihara D et al (2012) Modic changes in the cervical spine: prospective 10-year follow-up study in asymptomatic subjects. J Bone Joint Surg Br 94(5):678–683CrossRefPubMed Matsumoto M, Okada E, Ichihara D et al (2012) Modic changes in the cervical spine: prospective 10-year follow-up study in asymptomatic subjects. J Bone Joint Surg Br 94(5):678–683CrossRefPubMed
11.
go back to reference Sheng-Yun L, Letu S, Jian C, et al (2014) Comparison of Modic Changes in the Lumbar and Cervical Spine, in 3167 Patients with and without spinal pain. PLoS One 9(12):e114993 Sheng-Yun L, Letu S, Jian C, et al (2014) Comparison of Modic Changes in the Lumbar and Cervical Spine, in 3167 Patients with and without spinal pain. PLoS One 9(12):e114993
12.
go back to reference Li J, Li Y, Wei J, et al (2015)A study on the cervical spondylotic myelopathy treated by anterior cervical diskectomy and fusion in accordance with Modic changes with a 2-year minimum follow-up. J Orthop Surg Res 10(1):11 [Epub ahead of print] Li J, Li Y, Wei J, et al (2015)A study on the cervical spondylotic myelopathy treated by anterior cervical diskectomy and fusion in accordance with Modic changes with a 2-year minimum follow-up. J Orthop Surg Res 10(1):11 [Epub ahead of print]
13.
go back to reference Hayashi T, Daubs MD, Suzuki A et al (2014) Effect of Modic changes on spinal canal stenosis and segmental motion in cervical spine. Eur Spine J 23(8):1737–1742CrossRefPubMed Hayashi T, Daubs MD, Suzuki A et al (2014) Effect of Modic changes on spinal canal stenosis and segmental motion in cervical spine. Eur Spine J 23(8):1737–1742CrossRefPubMed
14.
go back to reference Dang AB, Hu SS, Tay BK. (2008) Biomechanics of the anterior longitudinal ligament during 8 g whiplash simulation following single- and contiguous two-level fusion: A finite element study. Spine (Phila Pa 1976) 33(6):607–611 Dang AB, Hu SS, Tay BK. (2008) Biomechanics of the anterior longitudinal ligament during 8 g whiplash simulation following single- and contiguous two-level fusion: A finite element study. Spine (Phila Pa 1976) 33(6):607–611
15.
go back to reference Bydon M, Xu R, Macki M et al (2014) Adjacent segment disease after anterior cervical discectomy and fusion in a large series. Neurosurgery 74(2):139–146CrossRefPubMed Bydon M, Xu R, Macki M et al (2014) Adjacent segment disease after anterior cervical discectomy and fusion in a large series. Neurosurgery 74(2):139–146CrossRefPubMed
Metadata
Title
The Impact of Modic-2 changes on the clinical outcomes of single-level anterior cervical discectomy and fusion
Authors
Jia Li
Tao Lei
Yong Shen
Publication date
01-12-2015
Publisher
Springer Berlin Heidelberg
Published in
European Spine Journal / Issue 12/2015
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-015-4161-1

Other articles of this Issue 12/2015

European Spine Journal 12/2015 Go to the issue