Kinematic analysis of the relationship between Modic changes and sagittal balance parameters in the cervical spine

Ma, Zhiyuan; Liu, Peng; Liu, Jingpei; Mou, Jianhui; Wang, Zhaolin; Sun, Dong; Cheng, Jie; Zhang, Dengwei; Xiao, Jianlin

doi:10.1097/md.0000000000007699

Cited by 17 publications

(15 citation statements)

References 22 publications

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“…As T1S decreases, a higher stress concentration is added onto the lower cervical spinal segments, such as C5–6 and C6–7, which worsens the symptoms of CS in the end and accelerates the process of degeneration. However, Ma et al [ 12 ] conducted a study that compared T1S between patients with and without Modic changes (MCs). The results showed that patients with MCs had a significantly higher T1S than those without MCs.…”

Section: Discussionmentioning

confidence: 99%

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The importance of preoperative T1 slope for determining proper postoperative C2–7 Cobb’s angle in patients undergoing cervical reconstruction

Chen

Wei

et al. 2020

J Orthop Surg Res

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Background This study aimed to explore the relationship among different cervical sagittal parameters in asymptomatic volunteers and the correlation between surgical efficacy and difference of presumed and actual postoperative C2–7 Cobbs’s angle (C2–7COBB), which was calculated based on preoperative T1 slope (T1S) in patients undergoing cervical reconstruction. Methods In total, 158 inpatients with cervical spondylosis and 274 asymptomatic volunteers were retrospectively reviewed. Cervical sagittal parameters, such as C2–7COBB, T1S, thoracic inlet angle (TIA), and neck tilt (NT), were compared. Then, the correlation among these parameters was analyzed in asymptomatic volunteers, and a regression equation between T1S and C2–7COBB was established and used to analyze the correlation among the Japanese Orthopaedic Association (JOA) score improvement, the sagittal parameters, and the difference between presumed and actual postoperative C2–7COBB in patients after cervical reconstruction. Results The mean T1S, C2–7COBB, and TIA were significantly decreased in patients (P < 0.01). T1S and NT had a strong correlation with TIA (P < 0.01). T1S demonstrated a moderate correlation with C2–7COBB in asymptomatic volunteers (r = 0.569, P < 0.01). A regression equation had been established as C2–7COBB = 0.742 × T1S − 0.866. The mean C2–7COBB and JOA score improved significantly (P < 0.05) postoperatively. Moreover, the JOA improvement rate showed a significant negative correlation with the difference in the presumed and actual postoperative C2–7COBB (r = − 0.696, P < 0.01). Conclusion Our study successfully established a regression equation for calculating postsurgical C2–7COBB based on the correlation between T1S and C2–7COBB in asymptomatic volunteers. The regression equation could be used for guiding surgeons to accomplish an ideal postsurgical C2–7COBB for patients with cervical spondylosis.

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Section: Discussionmentioning

confidence: 99%

“…It was assumed that people should have a large C2–7COBB to perform a horizontal gaze while they had a high T1S. The imbalance between C2–7COBB and T1S might be a key factor that accelerated the progression of degeneration [ 12 , 17 ].…”

Section: Discussionmentioning

confidence: 99%

The importance of preoperative T1 slope for determining proper postoperative C2–7 Cobb’s angle in patients undergoing cervical reconstruction

Chen

Wei

et al. 2020

J Orthop Surg Res

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“…A previous study conducted a retrospective review of 100 subjects, discussing the relationship between the cervical sagittal parameters, and the results concluded that T1 slope is a potential risk factor for the development of MC due to impaired sagittal balance, especially in the C5–C6 cervical segment [ 22 ]. Due to the limited sample size of the enrolled subjects of the previous study, we performed the present study with a total number of 300 subjects to explore the correlation between the occurrence of MC and sagittal alignment in the cervical spine.…”

Section: Discussionmentioning

confidence: 99%

Relationship Between Modic Changes and Sagittal Balance Parameters in the Cervical Spine

Wang

Xu³

et al. 2018

Med Sci Monit

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BackgroundWe explored the possible relationship between Modic changes (MCs) and sagittal parameters of the cervical spine.Material/MethodsWe enrolled 150 patients with cervical MC on the magnetic resonance imaging (MRI) scans in the MC (+) group and divided them into 3 sub-groups with 50 patients each: the MC1 sub-group, the MC2 sub-group, and the MC3 sub-group. Another 150 healthy subjects receiving routine health examinations were also enrolled in the study as the MC (−) group. The sagittal parameters in the cervical spine were measured and compared and multiple logistic regression analysis was performed to analyze the risk factor for the occurrence of MC.ResultsFour cervical sagittal parameters were measured and compared between all the enrolled groups, including neck tilt (NT), T1 slope (T1s), thoracic inlet angle (TIA), and Cobb C2–C7. The results confirmed that the parameter of Cobb C2–C7 was much smaller in the MC(+) group when compared with that in the MC(−) group (P<0.05), while no significant differences were detected between the MC(+) and MC(−) groups for the parameters of NT, T1 T1s, and TIA (P>0.05). Multiple logistic regression analysis showed that Cobb C2–C7 (less than 8.5°) could be regarded as the risk factor for the occurrence of MC, and the receiver operating characteristic (ROC) curve showed that moderate diagnostic significance was obtained with an area under curve (AUC) of 0.82.ConclusionsThe present study demonstrated that Cobb C2–C7 (less than 8.5°) is a potential risk factor for the development of MC.

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“…The reason for why more MCs are found on C6/7 than C4/5 in our study is interesting. Several authors have reported the effects of MCs on cervical sagittal balance and many of them suggested that patients with MCs have larger cervical curvature, larger T1 slope or C7S [21][22][23]. Higher T1 slope or C7S needs more CL to keep horizontal balance, which may cause more stress and hypermobility at the bottom of the cervical spine (C5/6 and C6/7), resulting in unusual mechanical stress and more endplate degeneration [21].…”

Section: Prevalence and Distribution Of The Cervical Mcsmentioning

confidence: 99%

Effect of Different Types of Modic Changes on Segmental Motion and Disc Degeneration in Cervical Spine

Zhang

Wang

et al. 2020

Preprint

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Background: Few studies have reported the segmental motion characteristics of different types of Modic changes (MCs) in the cervical spine in contrast to the lumbar spine. Considering the close relationship between MCs and disc degeneration (DD), this study is designed to elucidate the relationship of MCs with DD and DD-based angular motion in the cervical spine.Methods: MRI of C2/3~C6/7 from 594 patients were reviewed and those with MCs were selected and evaluated. MCs were defined as type 0, I, II, and III, and the grade of DD was classified from A to E (recorded from 1 to 5 points) as previously reported. DD score of each segment (sDD), total sDD of the entire cervical spine (tDD), and VAS score (neck pain) of each patient with MC were also recorded. Cervical lordosis (CL), C7 slope (C7S), segmental angular motion (sROM) and total angular motion of the entire cervical spine (tROM) were calculated from X-ray images.Results: Totally 135 MC segments were evaluated. In the two groups of DD D and DD E, the sROM of MC I and III segments are smaller than that of MC 0 segments, and the sROM of MC II segments are similar to that of MC 0. In addition, MC I segments present smaller sROM than that of MC II in the group of DD E, and their sROM are larger than that of MC III in the group of DD D. No difference is found in tROM between the patients with MC I, II and III. Our results also show that MC I and III segments are associated with high sDD and tDD scores. Finally, the patients with MC I have larger CL and C7S than those with MC III, and there is no statistical difference in VAS scores of neck pain between the patients with MC I, II and III. Conclusions: In the cervical spine, both MC I and III indicate decreased segmental angular motion and high disc degeneration grade. Cervical MCs may not be a sign of unstable neck pain or an indication for interbody fusion.

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Kinematic analysis of the relationship between Modic changes and sagittal balance parameters in the cervical spine

Cited by 17 publications

References 22 publications

The importance of preoperative T1 slope for determining proper postoperative C2–7 Cobb’s angle in patients undergoing cervical reconstruction

The importance of preoperative T1 slope for determining proper postoperative C2–7 Cobb’s angle in patients undergoing cervical reconstruction

Relationship Between Modic Changes and Sagittal Balance Parameters in the Cervical Spine

Effect of Different Types of Modic Changes on Segmental Motion and Disc Degeneration in Cervical Spine

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