Abstract
BackgroundThe aim of this research is to analyze the influence of Modic types on the clinical results of cervical spondylotic myelopathy treated by anterior cervical diskectomy and fusion.MethodsA total of 106 patients with a mean age of 55.8 ± 6.5 years were included in this study. Patients with Modic changes were retrospectively reviewed. In this study, 23 patients were classified as Modic-1, 39 patients were classified as Modic-2, and 44 patients were classified as Modic-0. Clinical evaluations were performed preoperatively and repeated at 3, 6, 12, and 24 months after operation.ResultsIn this study, all patients were followed up for a mean period of 30.2 months (range, from 24 to 36 months). Significant clinical improvement (P < 0.05) was observed in Japanese Orthopaedic Association (JOA) score and axial symptoms between the preoperative evaluation and the final follow-up. Comparing the result of mean JOA score after anterior cervical diskectomy and fusion (ACDF) in the Modic-1 group and other groups, statistically significant differences could be found at 12 months after surgery (P < 0.05). Comparing the outcome visual analog scale (VAS) of axial symptoms among different groups after ACDF, patients with Modic-1 changes showed significantly lower VAS of axial symptoms postoperatively (P < 0.05).ConclusionAfter anterior cervical diskectomy and fusion, both Modic-1 and Modic-2 groups showed excellent clinical outcomes over a 2-year follow-up. Better clinical results were achieved in patients with Modic-1 changes compared to the group of patients with Modic-2 and Modic-0 changes on magnetic resonance images.
Highlights
Cervical spondylotic myelopathy (CSM) is caused by spinal cord compression which is a common consequence of degenerative disk disease
The aim of this study is to evaluate the influence of Modic change type on the clinical outcome after ACDF
One of the inclusion criteria included the following: patients with chronic axial symptoms [12] resulting from single-level cervical disk degeneration, which is confirmed by cervical magnetic resonance images (MRI) and nonresponsive to appropriate nonsurgical treatment for at least 6 months
Summary
Cervical spondylotic myelopathy (CSM) is caused by spinal cord compression which is a common consequence of degenerative disk disease. Regardless of type, have been shown to be associated with degenerative changes of the intervertebral disk and chronic low back pain [6,7,8]. The precise clinical relevance of Modic changes is a controversy, there have been many studies to explore the relation between Modic change and chronic low back pain. The aim of this research is to analyze the influence of Modic types on the clinical results of cervical spondylotic myelopathy treated by anterior cervical diskectomy and fusion
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