Li Jia, Zhang Jingtao, Tong Tong, Shen Yong
Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, China.
The Key Laboratory of Orthopedic Biomechanics of Hebei Province, The Third Hospital of Hebei Medical University, Shijiazhuang, China.
J Invest Surg. 2022 Feb;35(2):301-307. doi: 10.1080/08941939.2020.1855487. Epub 2020 Dec 7.
This retrospective study aimed to determine the impact of Modic changes (MCs) on cage subsidence (CS) and intervertebral fusion after anterior cervical corpectomy and fusion (ACCF).
This study enrolled 61 patients with MCs who underwent single-level ACCF between January 2010 and December 2015 at our institution. The control group included 63 age-matched patients without MCs treated during the same period. The results from clinical and radiological assessments were reviewed, and radiographic CS was defined by an intervertebral height at the final follow-up that was less than the postoperative intervertebral height.
No significant differences in gender, age, operative time, blood loss, or follow-up results were observed between the MCs and control groups. Significantly more patients experienced CS in the MCs group than in the control group (41.0% vs. 15.9%; = 0.003). The frequencies of CS among patients with type I MCs (40.0%, 8/20) and type II MCs (41.5%, 17/41) were significantly higher than that in the control group (15.9%, 10/63; < 0.05). Both groups showed significant improvements in clinical assessment scores after surgery and at final follow-up compared with preoperative values ( < 0.05).
In summary, all 61 patients with MCs who underwent ACCF achieved good fusion results. MCs in the surgical segment had no significant effect on intervertebral fusion, but both type 1 and type 2 MCs may increase the risk of CS.
本回顾性研究旨在确定Modic改变（MCs）对颈椎前路椎体次全切除融合术（ACCF）后椎间融合器下沉（CS）和椎间融合的影响。
本研究纳入了2010年1月至2015年12月在我院接受单节段ACCF的61例患有MCs的患者。对照组包括同期治疗的63例年龄匹配且无MCs的患者。回顾了临床和影像学评估结果，影像学CS定义为末次随访时的椎间高度小于术后椎间高度。
MCs组和对照组在性别、年龄、手术时间、失血量或随访结果方面未观察到显著差异。MCs组发生CS的患者明显多于对照组（41.0%对15.9%；P = 0.003）。I型MCs患者（40.0%，8/20）和II型MCs患者（41.5%，17/41）的CS发生率显著高于对照组（15.9%，10/63；P < 0.05）。与术前值相比，两组在术后和末次随访时的临床评估评分均有显著改善（P < 0.05）。
总之，所有接受ACCF的61例患有MCs的患者均获得了良好的融合效果。手术节段的MCs对椎间融合无显著影响，但I型和II型MCs均可能增加CS的风险。
