Clinical and Radiological Outcomes of Cervical Disc Arthroplasty in Patients with Modic Change

Autor: Yifei Deng, Xiaqing Sheng, Beiyu Wang, Ying Hong, Xing Rong, Chen Ding, Hao Liu
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: Orthopaedic Surgery, Vol 16, Iss 7, Pp 1562-1570 (2024)
Druh dokumentu: article
ISSN: 1757-7861
1757-7853
DOI: 10.1111/os.14085
Popis: Objective Modic change (MC) is defined as abnormalities observed in the intervertebral disc subchondral and adjacent vertebral endplate subchondral bone changes. Most studies on MC were reported in the lumbar spine and associated with lower back pain. However, MC has been rarely reported in the cervical spine, let alone in those who underwent cervical disc replacement (CDR). This study aimed to focus on MC in the cervical spine and reveal clinical and radiological parameters, especially heterotopic ossification (HO), for patients who underwent CDR. Furthermore, we illustrated the association between MC and HO. Methods We retrospectively reviewed patients who underwent CDA from January 2008 to December 2019. The Japanese Orthopaedic Association (JOA), Neck Disability Index (NDI), and Visual Analog Scale (VAS) scores were used to evaluate the clinical outcomes. Radiological evaluations were used to conclude the cervical alignment (CL) and range of motion (ROM) of C2‐7, functional spinal unit angle (FSUA), shell angle (SA), FSU height, and HO. Univariate and multivariate logistic regressions were performed to identify the risk factors for HO. The Kaplan–Meier (K‐M) method was used to analyze potential risk factors, and multivariate Cox regression was used to identify independent risk factors. Results A total of 139 patients were evaluated, with a mean follow‐up time of 46.53 ± 26.60 months. Forty‐nine patients were assigned to the MC group and 90 to the non‐MC group. The incidence of MC was 35.3%, with type 2 being the most common. Clinical outcomes (JOA, NDI, VAS) showed no significant difference between the two groups. The differences in C2‐7 ROM between the two groups were not significant, while the differences in SA ROM and FSUA ROM were significantly higher in the non‐MC than in the MC group (p
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