Preoperative Modic changes are related to axial symptoms after anterior cervical discectomy and fusion
Authors Zhou J, Li L, Li T, Xue Y
Received 3 May 2018
Accepted for publication 21 August 2018
Published 26 October 2018 Volume 2018:11 Pages 2617—2623
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 4
Editor who approved publication: Dr E Alfonso Romero-Sandoval
Jiaming Zhou,1 Liandong Li,1 Tengshuai Li,2 Yuan Xue1
1Department of Orthopedics Surgery, Tianjin Medical University General Hospital, Heping District, Tianjin 300052, People’s Republic of China; 2Department of Orthopedics Surgery, Tianjin Hospital, Hexi District, Tianjin 300211, People’s Republic of China
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 (P=0.013) and at final follow-up (P<0.001) and preoperative segmental angle (P=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 (P>0.05). Logistic regression analysis revealed that preoperative segmental kyphosis (OR =2.912, P=0.035) and MCs (odds ratio =3.268, P=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.
Keywords: anterior cervical discectomy and fusion, cervical spondylotic myelopathy, axial symptoms, segmental angle, Modic changes
This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.Download Article [PDF] View Full Text [HTML][Machine readable]