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European Spine Journal

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01-07-2017 | Original Article

Do Modic changes affect cervical sagittal alignment and motion in symptomatic patients?

Authors: Tong Tong, Xian-Da Gao, Jia Li, Jing-Tao Zhang, Rui-Jie Niu, Zhao Liu, Yong Shen

Published in: European Spine Journal | Issue 7/2017

Abstract

Purpose

The cervical segmental instability often occurs simultaneously with Modic changes (MCs). However, it is unknown whether there is a relation between the two diseases. The aim of this study was to evaluate the relationship between MCs and cervical segmental instability, cervical curvature and range of motion (ROM) in the cervical spine.

Methods

A total of 464 patients with neck pain or cervical neurologic symptoms who underwent imaging examination were analyzed retrospectively. Based on MRI imaging cervical MCs were diagnosed, and patients were divided into with or without MCs groups. The cervical curvature and range of motion were measured. We compared the incidence of cervical instability, cervical curvature and ROM between the two group patients and their relationships with MCs were studied. Logistic regression was used to study the risk factors associated with MCs.

Results

MCs were observed in 94 of 464 patients and 122 of total 2320 cervical segments and were most frequent at C5–6 segment. The incidence of the cervical instability was significantly higher in patients with MCs than those without MCs at cervical level C3–7. In addition, cervical curvature and ROM in patients with MCs were less than those without MCs. Logistic regression analysis showed that the occurrence of cervical spine instability, less cervical curvature and ROM were risk factors for MCs.

Conclusions

Patients with MCs were prone to have cervical instability at the same cervical level and may have a higher possibility of less cervical curvature and ROM.

Modic MT, Masaryk TJ, Ross JS, Carter JR (1988) Imaging of degenerative disk disease. Radiology 168(1):177–186CrossRefPubMed

Kjaer P, Leboeuf-Yde C, Korsholm L, Sorensen JS, Bendix T (2005) Magnetic resonance imaging and low back pain in adults: a diagnostic imaging study of 40-year-old men and women. Spine (Phila Pa 1976) 30(10):1173–1180CrossRef

Sheng-yun L, Letu S, Jian C, Mamuti M, Jun-hui L, Zhi S, Chong-yan W, Shunwu F, Zhao F (2014) Comparison of modic changes in the lumbar and cervical spine, in 3167 patients with and without spinal pain. PLoS One 9(12):e114993CrossRefPubMedPubMedCentral

Li J, Zhang D, Ding W, Zhang Y, Shen Y (2014) Comparison of clinical outcomes after anterior cervical discectomy and fusion versus cervical total disc replacement in patients with Modic-2 changes on MRI. J Spinal Disord Tech. doi:10.1097/BSD.0000000000000226

Park MS, Moon SH, Kim TH, Lee SY, Jo YG, Riew KD (2015) Relationship between modic changes and facet joint degeneration in the cervical spine. Eur Spine J 24(12):2999–3004CrossRefPubMed

Rajasekaran S, Tangavel C, Aiyer SN, Nayagam SM, Raveendran M, Demonte NL, Subbaiah P, Kanna R, Shetty AP, Dharmalingam K (2017) Is infection the possible initiator of disc disease? An insight from proteomic analysis. Eur Spine J. doi:10.1007/s00586-017-4972-3

Böker SM, Bender YY, Adams LC, Fallenberg EM, Wagner M, Hamm B, Makowski MR (2017) Evaluation of sclerosis in Modic changes of the spine using susceptibility-weighted magnetic resonance imaging. Eur J Radiol 88:148–154CrossRefPubMed

Mann E, Peterson CK, Hodler J, Pfirrmann CW (2014) The evolution of degenerative marrow (Modic) changes in the cervical spine in neck pain patients. Eur Spine J 23(3):584–589CrossRefPubMed

Garfin SR, Ahlgren BD (1995) Current management of cervical spine instability. Curr Opin Rheumatol 7(2):114–119CrossRefPubMed

10.

Ng HW, Teo EC, Lee KK, Qiu TX (2003) Finite element analysis of cervical spinal instability under physiologic loading. J Spinal Disord Tech 16(1):55–65CrossRefPubMed

11.

Kawakami M, Tamaki T, Ando M, Yamada H, Matsumoto T, Yoshida M (2002) Preoperative instability does not influence the clinical outcome in patients with cervical spondylotic myelopathy treated with expansive laminoplasty. J Spinal Disord Tech 15(4):277–283CrossRefPubMed

12.

Qian J, Tian Y, Qiu GX, Hu JH (2009) Dynamic radiographic analysis of sympathetic cervical spondylosis instability. Chin Med Sci J 24(1):46–49CrossRefPubMed

13.

Ratliff J, Voorhies R (2000) Increased MRI signal intensity in association with myelopathy and cervical instability: case report and review of the literature. Surg Neurol 53(1):8–13CrossRefPubMed

14.

Dai L (1998) Disc degeneration and cervical instability. Correlation of magnetic resonance imaging with radiography. Spine (Phila Pa 1976) 23(16):1734–1738CrossRef

15.

White AA 3rd, Johnson RM, Panjabi MM, Southwick WO (1975) Biomechanical analysis of clinical stability in the cervical spine. Clin Orthop Relat Res 109:85–96CrossRef

16.

Harrison DE, Harrison DD, Cailliet R, Troyanovich SJ, Janik TJ, Holland B (2000) Cobb method or Harrison posterior tangent method: which to choose for lateral cervical radiographic analysis. Spine (Phila Pa 1976) 25(16):2072–2078CrossRef

17.

Ohara A, Miyamoto K, Naganawa T, Matsumoto K, Shimizu K (2006) Reliabilities of and correlations among five standard methods of assessing the sagittal alignment of the cervical spine. Spine (Phila Pa 1976) 31(22):2585–2591 (discussion 2592) CrossRef

18.

Penning L (1978) Normal movements of the cervical spine. AJR Am J Roentogenol 130:317–326CrossRef

19.

Machino M, Yukawa Y, Hida T, Ito K, Nakashima H, Kanbara S, Morita D, Kato F (2012) Cervical alignment and range of motion after laminoplasty: radiographical data from more than 500 cases with cervical spondylotic myelopathy and a review of the literature. Spine (Phila Pa 1976) 37(20):E1243–E1250CrossRef

20.

Landis JR, Koch GG (1977) The measurement of observer agreement for categorical data. Biometrics 33(1):159–174CrossRefPubMed

21.

Wang B, Liu H, Wang H, Zhou D (2006) Segmental instability in cervical spondylotic myelopathy with severe disc degeneration. Spine (Phila Pa 1976) 31(12):1327–1331CrossRef

22.

Yu Z, Liu Z, Dang G (2002) Effect of cervical instability in sympathetic cervical spondylosis. Zhonghua Wai Ke Za Zhi 40(12):881–885PubMed

23.

Hayashi T, Daubs MD, Suzuki A, Scott TP, Phan KH, Ruangchainikom M, Takahashi S, Shiba K, Wang JC (2015) Motion characteristics and related factors of Modic changes in the lumbar spine. J Neurosurg Spine 22(5):511–517CrossRefPubMed

24.

Hayashi T, Daubs MD, Suzuki A, Phan K, Shiba K, Wang JC (2014) Effect of Modic changes on spinal canal stenosis and segmental motion in cervical spine. Eur Spine J 23(8):1737–1742CrossRefPubMed

25.

Wang YX, Griffith JF (2011) Menopause causes vertebral endplate degeneration and decrease in nutrient diffusion to the intervertebral discs. Med Hypotheses 77(1):18–20CrossRefPubMed

26.

Anderson JS, Hsu AW, Vasavada AN (2005) Morphology, architecture, and biomechanics of human cervical multifidus. Spine (Phila Pa 1976) 30(4):86–91CrossRef

27.

De Pauw R, Coppieters I, Kregel J, De Meulemeester K, Danneels L, Cagnie B (2016) Does muscle morphology change in chronic neck pain patients? A systematic review. Man Ther 22:42–49CrossRefPubMed

28.

Steilen D, Hauser R, Woldin B, Sawyer S (2014) Chronic neck pain: making the connection between capsular ligament laxity and cervical instability. Open Orthop J 8:326–345CrossRefPubMedPubMedCentral

29.

Davies BM, Atkinson RA, Ludwinski F, Freemont AJ, Hoyland JA, Gnanalingham KK (2016) Qualitative grading of disc degeneration by magnetic resonance in the lumbar and cervical spine: lack of correlation with histology in surgical cases. Br J Neurosurg 30(4):414–421CrossRefPubMed

30.

de Bruin F, Ter HS, van den Berg R, de Hooge M, van Gaalen F, Fagerli KM, Landewé R, van Oosterhout M, Bloem JL, van der Heijde D, Reijnierse M (2016) Signal intensity loss of the intervertebral discs in the cervical spine of young patients on fluid sensitive sequences. Skeletal Radiol 45(3):375–381CrossRefPubMed

31.

Chen CJ, Hsu HL, Niu CC, Chen TY, Chen MC, Tseng YC, Wong YC, Wang LJ (2003) Cervical degenerative disease at flexion-extension MR imaging: prediction criteria. Radiology 227(1):136–142CrossRefPubMed

Title: Do Modic changes affect cervical sagittal alignment and motion in symptomatic patients?
Authors: Tong Tong
Xian-Da Gao
Jia Li
Jing-Tao Zhang
Rui-Jie Niu
Zhao Liu
Yong Shen
Publication date: 01-07-2017
Publisher: Springer Berlin Heidelberg
Published in: European Spine Journal / Issue 7/2017
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-017-5098-3

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Do Modic changes affect cervical sagittal alignment and motion in symptomatic patients?

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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