The aim of this study is to investigate the relationship between the Modic changes (MCs) and sagittal parameters of the cervical spine.We conducted a retrospective review of 100 outpatients with magnetic resonance imaging (MRI) scans of the cervical spine (50 male and 50 female). MRI parameters were measured, including neck tilt, T1 slope (T1 ), thoracic inlet angle (TIA), and cervical lordosis (CL: Cobb C2–7). Patients were divided into 4 groups according to the presence or absence of MC and T1s, respectively: MC(+) and MC(−) groups, as well as H-T1s (T1s ≥25°) and L-T1s subgroups (T1s <25°). Relationships between the MC and sagittal alignment in the cervical spine and other parameters were evaluated via Spearman correlation coefficient. Radiologic parameters were compared between the MC(+) group and MC(−) group, and the prevalences of MC were compared between the H-T1s and L-T1s groups.T1s was significantly correlated with TIA and CL, with correlation coefficients of 0.562 and 0.725, respectively. T1 slope was significantly higher in patients with MC than those without MC (P = .041), and the prevalence of MC was higher in the H-T1s group than the L-T1s group (37.5% and 17.1%, respectively). However, the relationship between the parameters of sagittal balance and MC was not significant.The present study demonstrated that high T1 slope is a potential risk factor for the development of MC due to impaired sagittal balance, especially in the C5–6 cervical segment.

BackgroundThe aim of this study was to explore the correlations between the different parameters of the cervical sagittal balance in magnetic resonance images (MRI) and evaluate the criteria for their clinical application in disc-degenerative diseases.Material/MethodsWe conducted a retrospective review of the MRIs of 125 adult outpatients with disc-degenerative diseases of the cervical spine; the images were obtained between May and July 2014 at our institute. The control group comprised 50 volunteers whose MRIs were also obtained. The parameters measured in the MRIs were: neck tilt (NT), T1 slope (T1S), thoracic inlet angle (TIA), and Cobb’s angle (C2–7). The correlation between the various parameters was analyzed using the Pearson correlation coefficient.ResultsThe outpatients group showed moderate correlation between TIA and T1S, a significant correlation between TIA and NT, a weak correlation between T1S and Cobb’s angle, and a weakly negative correlation between T1S and NT. Further, the TIA showed no significant difference between the outpatient group and the control group, as per the sample t test.ConclusionsOur findings indicate that TIA, T1S, and NT could be used as indices for the evaluation of cervical sagittal balance and that the TIA could be used as a reference to assess the cervical compensation. Restoration of the NT and T1S should be considered as a goal of surgical treatment during the preoperative planning in patients with disc-degenerative diseases.

To investigate the relationship between cervical and thoracic sagittal alignment parameters measured by magnetic resonance imaging (MRI) and x-ray in patients with cervical spondylosis Data from 120 symptomatic patients who presented with cervical spondylosis between April 2015 and January 2016 were retrospectively analyzed. Patients received both a cervical MRI and a cervical radiograph during a single visit. The thoracic inlet angle (TIA), T1 slope (T1S), neck tilt (NT), C2-C7 angle (C2-C7), and C2-C7 sagittal vertical axis (C2–7 SVA) were assessed. Pearson correlation coefficient, paired t test, and linear regression models were used to analyze parameters obtained by cervical MRI and radiography. The difference in mean thoracic inlet angle x-ray (TIAX) and thoracic inlet angle MRI (TIAM) (TIAM–TIAX) (0.72 ± 5.82°) was not significant ( P > .05). There were significant differences in mean T1 slope x-ray (T1SX) and T1 slope MRI (T1SM) (T1SM-T1SX) (-2.55 ± 6.14°), mean neck tilt x-ray (NTX) and neck tilt MRI (NTM) (NTM-NTX) (3.26 ± 6.01°), mean C2-C7 angle x-ray (C2–7X) and C2-C7 angle MRI (C2–7 M) (C2–7M-C2–7X) (−3.57 ± 10.00°), and mean C2-C7 sagittal vertical axis X ray (C2–7 SVAX) and C2-C7 sagittal vertical axis MRI (C2–7 SVAM) (C2–7 SVAM-C2–7 SVAX) (-4.50 ± 1.26 mm) (all P ≤ .001). There were positive correlations between TIAM and TIAX ( r = 0.807), T1SM and T1SX ( r = 0.581), NTM and NTX ( r = 0.759), cervical loidosis MRI and cervical loidosis x-ray ( r = 0.666), and SVAM and SVAX ( r = 0.226). MRI may be useful to evaluate thoracic inlet and sagittal alignment parameters in patients with cervical spondylosis. Patients with cervical spondylosis may have a relatively low capacity for compensation in the cervical region.