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Erschienen in: European Spine Journal 7/2017

18.04.2017 | Original Article

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

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

Erschienen in: European Spine Journal | Ausgabe 7/2017

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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.
Literatur
1.
Zurück zum Zitat Modic MT, Masaryk TJ, Ross JS, Carter JR (1988) Imaging of degenerative disk disease. Radiology 168(1):177–186CrossRefPubMed Modic MT, Masaryk TJ, Ross JS, Carter JR (1988) Imaging of degenerative disk disease. Radiology 168(1):177–186CrossRefPubMed
2.
Zurück zum Zitat 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 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
3.
Zurück zum Zitat 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 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
4.
Zurück zum Zitat 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 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​
5.
Zurück zum Zitat 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 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
6.
Zurück zum Zitat 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 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
7.
Zurück zum Zitat 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 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
8.
Zurück zum Zitat 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 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
9.
Zurück zum Zitat Garfin SR, Ahlgren BD (1995) Current management of cervical spine instability. Curr Opin Rheumatol 7(2):114–119CrossRefPubMed Garfin SR, Ahlgren BD (1995) Current management of cervical spine instability. Curr Opin Rheumatol 7(2):114–119CrossRefPubMed
10.
Zurück zum Zitat 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 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.
Zurück zum Zitat 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 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.
Zurück zum Zitat 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 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.
Zurück zum Zitat 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 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.
Zurück zum Zitat Dai L (1998) Disc degeneration and cervical instability. Correlation of magnetic resonance imaging with radiography. Spine (Phila Pa 1976) 23(16):1734–1738CrossRef Dai L (1998) Disc degeneration and cervical instability. Correlation of magnetic resonance imaging with radiography. Spine (Phila Pa 1976) 23(16):1734–1738CrossRef
15.
Zurück zum Zitat 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 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.
Zurück zum Zitat 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 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.
Zurück zum Zitat 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 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.
Zurück zum Zitat Penning L (1978) Normal movements of the cervical spine. AJR Am J Roentogenol 130:317–326CrossRef Penning L (1978) Normal movements of the cervical spine. AJR Am J Roentogenol 130:317–326CrossRef
19.
Zurück zum Zitat 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 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.
Zurück zum Zitat Landis JR, Koch GG (1977) The measurement of observer agreement for categorical data. Biometrics 33(1):159–174CrossRefPubMed Landis JR, Koch GG (1977) The measurement of observer agreement for categorical data. Biometrics 33(1):159–174CrossRefPubMed
21.
Zurück zum Zitat 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 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.
Zurück zum Zitat Yu Z, Liu Z, Dang G (2002) Effect of cervical instability in sympathetic cervical spondylosis. Zhonghua Wai Ke Za Zhi 40(12):881–885PubMed 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.
Zurück zum Zitat 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 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.
Zurück zum Zitat 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 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.
Zurück zum Zitat 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 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.
Zurück zum Zitat Anderson JS, Hsu AW, Vasavada AN (2005) Morphology, architecture, and biomechanics of human cervical multifidus. Spine (Phila Pa 1976) 30(4):86–91CrossRef Anderson JS, Hsu AW, Vasavada AN (2005) Morphology, architecture, and biomechanics of human cervical multifidus. Spine (Phila Pa 1976) 30(4):86–91CrossRef
27.
Zurück zum Zitat 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 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.
Zurück zum Zitat 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 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.
Zurück zum Zitat 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 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.
Zurück zum Zitat 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 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.
Zurück zum Zitat 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 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
Metadaten
Titel
Do Modic changes affect cervical sagittal alignment and motion in symptomatic patients?
verfasst von
Tong Tong
Xian-Da Gao
Jia Li
Jing-Tao Zhang
Rui-Jie Niu
Zhao Liu
Yong Shen
Publikationsdatum
18.04.2017
Verlag
Springer Berlin Heidelberg
Erschienen in
European Spine Journal / Ausgabe 7/2017
Print ISSN: 0940-6719
Elektronische ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-017-5098-3

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