{"title":"ACDF 术后,Modic 变异 2 型与非融合节段的终板缺损密切相关。","authors":"Olga Leonova, Evgeniy Baykov, Aleksandr Krutko","doi":"10.1016/j.wneu.2024.10.079","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>To determine the association between Modic changes (MCs) with other magnetic resonance imaging parameters and clinical symptoms of cervical degenerative disc disease.</p><p><strong>Methods: </strong>A retrospective analysis of data on patients with cervical degenerative disc disease who underwent single-level anterior cervical discectomy and fusion. Preoperative demographic data (age, sex, surgical data) were collected, cervical magnetic resonance imaging parameters (disc degeneration grade, MCs, and endplate defects, each determined at each cervical level), and clinical data (numerical pain rating scale [NPRS] neck and arm, the Neck Disability Index) were compared to preoperative data.</p><p><strong>Results: </strong>The study included 121 patients at Visit 1 and 83 patients at Visit 2. The median follow-up duration was 26.5 [18.9; 33.1] months. Patients with MC had more intense NPRS-based neck pain before surgery compared to patients without MC (P = 0.001). There were significant changes in MC rate at the C5-C6 levels due to a significant number of new MC type 1 and MC type 2 (P = 0.002 and P < 0.001, respectively). MC type 2 was associated with disc degeneration, endplate defects, patients' age, and clinical scales (Neck Disability Index, NPRS) (P < 0.05). The endplate defects score threshold for predicting MC type 2 at the C3-C7 cervical levels was 5.</p><p><strong>Conclusions: </strong>The factor predicting MC type 2 at the C3-C7 cervical levels is submaximal damage to the endplate. The MC rate is increased due to MC type 1 and MC type 2. MC types at the cervical levels may not represent consecutive stages of the same process.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"825-832"},"PeriodicalIF":1.9000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"A Strong Association Between Modic Changes Type 2 and Endplate Defects at Nonfused Segments After Anterior Cervical Decompression and Fusion.\",\"authors\":\"Olga Leonova, Evgeniy Baykov, Aleksandr Krutko\",\"doi\":\"10.1016/j.wneu.2024.10.079\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>To determine the association between Modic changes (MCs) with other magnetic resonance imaging parameters and clinical symptoms of cervical degenerative disc disease.</p><p><strong>Methods: </strong>A retrospective analysis of data on patients with cervical degenerative disc disease who underwent single-level anterior cervical discectomy and fusion. Preoperative demographic data (age, sex, surgical data) were collected, cervical magnetic resonance imaging parameters (disc degeneration grade, MCs, and endplate defects, each determined at each cervical level), and clinical data (numerical pain rating scale [NPRS] neck and arm, the Neck Disability Index) were compared to preoperative data.</p><p><strong>Results: </strong>The study included 121 patients at Visit 1 and 83 patients at Visit 2. The median follow-up duration was 26.5 [18.9; 33.1] months. Patients with MC had more intense NPRS-based neck pain before surgery compared to patients without MC (P = 0.001). There were significant changes in MC rate at the C5-C6 levels due to a significant number of new MC type 1 and MC type 2 (P = 0.002 and P < 0.001, respectively). MC type 2 was associated with disc degeneration, endplate defects, patients' age, and clinical scales (Neck Disability Index, NPRS) (P < 0.05). The endplate defects score threshold for predicting MC type 2 at the C3-C7 cervical levels was 5.</p><p><strong>Conclusions: </strong>The factor predicting MC type 2 at the C3-C7 cervical levels is submaximal damage to the endplate. The MC rate is increased due to MC type 1 and MC type 2. MC types at the cervical levels may not represent consecutive stages of the same process.</p>\",\"PeriodicalId\":23906,\"journal\":{\"name\":\"World neurosurgery\",\"volume\":\" \",\"pages\":\"825-832\"},\"PeriodicalIF\":1.9000,\"publicationDate\":\"2025-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"World neurosurgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.wneu.2024.10.079\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/11/14 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"World neurosurgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.wneu.2024.10.079","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/11/14 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
摘要
目的:确定颈椎间盘退行性病变(DDD)的莫迪克变化(MC)与其他 MRI 参数和临床症状之间的关联:对接受单层颈椎椎间盘前路切除术和融合术的颈椎退行性病变患者的数据进行回顾性分析。收集术前人口统计学数据(年龄、性别、手术数据)、颈椎磁共振成像参数(椎间盘退变等级、MC和终板缺损,分别在每个颈椎水平测定)以及临床数据(颈部和手臂疼痛评分量表(NPRS)、颈部残疾指数(NDI))与术前数据进行比较:研究结果:121名患者接受了访视1,83名患者接受了访视2。中位随访时间为 26.5 [18.9; 33.1] 个月。与无 MC 的患者相比,有 MC 的患者术前的 NPRS 颈部疼痛更剧烈(P=0.001)。C5-C6水平的MC率有明显变化,原因是新增了大量1型MC和2型MC(P=0.002和P结论:预测颈椎C3-C7水平MC 2型的因素是终板的亚极度损伤。MC1型和MC2型会增加MC率。颈椎水平的 MC 类型可能并不代表同一过程的连续阶段。
A Strong Association Between Modic Changes Type 2 and Endplate Defects at Nonfused Segments After Anterior Cervical Decompression and Fusion.
Background: To determine the association between Modic changes (MCs) with other magnetic resonance imaging parameters and clinical symptoms of cervical degenerative disc disease.
Methods: A retrospective analysis of data on patients with cervical degenerative disc disease who underwent single-level anterior cervical discectomy and fusion. Preoperative demographic data (age, sex, surgical data) were collected, cervical magnetic resonance imaging parameters (disc degeneration grade, MCs, and endplate defects, each determined at each cervical level), and clinical data (numerical pain rating scale [NPRS] neck and arm, the Neck Disability Index) were compared to preoperative data.
Results: The study included 121 patients at Visit 1 and 83 patients at Visit 2. The median follow-up duration was 26.5 [18.9; 33.1] months. Patients with MC had more intense NPRS-based neck pain before surgery compared to patients without MC (P = 0.001). There were significant changes in MC rate at the C5-C6 levels due to a significant number of new MC type 1 and MC type 2 (P = 0.002 and P < 0.001, respectively). MC type 2 was associated with disc degeneration, endplate defects, patients' age, and clinical scales (Neck Disability Index, NPRS) (P < 0.05). The endplate defects score threshold for predicting MC type 2 at the C3-C7 cervical levels was 5.
Conclusions: The factor predicting MC type 2 at the C3-C7 cervical levels is submaximal damage to the endplate. The MC rate is increased due to MC type 1 and MC type 2. MC types at the cervical levels may not represent consecutive stages of the same process.
期刊介绍:
World Neurosurgery has an open access mirror journal World Neurosurgery: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review.
The journal''s mission is to:
-To provide a first-class international forum and a 2-way conduit for dialogue that is relevant to neurosurgeons and providers who care for neurosurgery patients. The categories of the exchanged information include clinical and basic science, as well as global information that provide social, political, educational, economic, cultural or societal insights and knowledge that are of significance and relevance to worldwide neurosurgery patient care.
-To act as a primary intellectual catalyst for the stimulation of creativity, the creation of new knowledge, and the enhancement of quality neurosurgical care worldwide.
-To provide a forum for communication that enriches the lives of all neurosurgeons and their colleagues; and, in so doing, enriches the lives of their patients.
Topics to be addressed in World Neurosurgery include: EDUCATION, ECONOMICS, RESEARCH, POLITICS, HISTORY, CULTURE, CLINICAL SCIENCE, LABORATORY SCIENCE, TECHNOLOGY, OPERATIVE TECHNIQUES, CLINICAL IMAGES, VIDEOS