Abstract
Objective: This study evaluates the relationship between degenerative and Modic changes (MCs) in the cervical spine and compares the results with the cervical sagittal balance parameters.Methods: We retrospectively reviewed 275 patients with neck pain who applied to our outpatient clinic and underwent cervical magnetic resonance imaging (MRI) and cervical anteroposterior (AP)/lateral (Lat) X-ray radiography between January 2016 and January 2018. The clinics, demographic information, and radiological findings of the patients were examined. Modic changes, disc degeneration, and facet degeneration (FD) were examined by cervical MRI, and T1 slope and Cobb angle were measured by cervical AP/Lat X-ray radiography. These results were compared to evaluate their relations with each other.Results: No relationship between the presence or absence of degenerative changes (Modic changes, facet degeneration, and disc degeneration) and sagittal balance parameters (T1 slope and Cobb angle) was found. However, when each cervical segment was examined separately, facet degeneration at the C4-C5 level and Modic changes at the C3-C4, C4-C5, and C6-C7 levels were statistically significant with the Cobb angles, and the Modic changes at the C3-C4 level and disc degeneration at the C2-C3 level were found to be significant with T1 slope values.Conclusions: Our findings indicate that MCs increased with decreased cervical curvature, increasing disc and facet degeneration, although the causal mechanisms are not clear.
Highlights
Neck pain is an important factor affecting daily activities
When each cervical segment was examined separately, facet degeneration at the C4-C5 level and Modic changes at the C3-C4, C4-C5, and C6-C7 levels were statistically significant with the Cobb angles, and the Modic changes at the C3-C4 level and disc degeneration at the C2-C3 level were found to be significant with T1 slope values
Our findings indicate that Modic changes (MCs) increased with decreased cervical curvature, increasing disc and facet degeneration, the causal mechanisms are not clear
Summary
Neck pain is an important factor affecting daily activities. the leading causes of neck pain include disc herniation, disc degeneration (DD), spinal stenosis, and muscle spasm, it is often assumed that neck pain is multifactorial. Studies have reported on the relationship between degenerative spine changes such as DD, disc displacement, Schmorl nodes, and facet degeneration (FD) with Modic changes (MCs) in the cervical spine and pain [2,3,4,5]. MC is defined as signal changes in the subchondral bone marrow on magnetic resonance images (MRI) in patients with degenerative spine. They are classified into three types according to the signal changes seen in T1- and T2-weighted images in MRI. Type 1 is hypointense on T1-weighted MRI and hyperintense on T2weighted MRI and is detected in inflamed areas. Type 2 is hyperintense on T1- and T2-weighted MR images and is detected in areas with fatty degeneration. Type 3 is detected in areas with hypointense and sclerosis on T1- and T2-weighted MR images [9]
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