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      Journal of Pain Research (submit here)

      This international, peer-reviewed Open Access journal by Dove Medical Press focuses on reporting of high-quality laboratory and clinical findings in all fields of pain research and the prevention and management of pain. Sign up for email alerts here.

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      Is Open Access

      Preoperative Modic changes are related to axial symptoms after anterior cervical discectomy and fusion

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          Abstract

          Background

          The objective of this study was to compare the clinical and radiological outcomes between patients with or without axial symptoms (AS) and investigate the risk factors associated with AS by multivariate regression analysis in anterior cervical discectomy and fusion (ACDF).

          Materials and methods

          The records of 117 patients who underwent ACDF were reviewed for clinical and radiological outcomes. These outcomes were evaluated before and after surgery and at the last follow-up. Preoperative Modic changes (MCs) adjacent to the treated disc were identified. Risk factors for AS were detected through logistic regression analysis.

          Results

          The patients were divided into two groups: one with AS (AS group, n=35) and the other without (NAS group, n=82). Visual Analog Scale values after the operation ( P=0.013) and at final follow-up ( P<0.001) and preoperative segmental angle ( P=0.031) were significantly different between the two groups. There were no significant differences with respect to other clinical and radiographic outcomes between the two groups ( P>0.05). Logistic regression analysis revealed that preoperative segmental kyphosis (OR =2.912, P=0.035) and MCs (odds ratio =3.268, P=0.015) were the risk factors for the occurrence of AS.

          Conclusion

          AS do not correlate with recovery of neural function in patients treated by ACDF. In addition, preoperative segmental kyphosis and MCs at the fusion segment were found to affect the incidence of AS after ACDF.

          Most cited references30

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          The treatment of certain cervical-spine disorders by anterior removal of the intervertebral disc and interbody fusion.

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            Imaging of degenerative disk disease.

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              Degenerative disk disease: assessment of changes in vertebral body marrow with MR imaging.

              The authors reviewed magnetic resonance (MR) images of 474 consecutive patients referred for lumbar spine MR imaging. Type 1 changes (decreased signal intensity on T1-weighted spin-echo images and increased signal intensity on T2-weighted images) were identified in 20 patients (4%) and type 2 (increased signal intensity on T1-weighted images and isointense or slightly increased signal intensity on T2-weighted images) in 77 patients (16%). In all cases there was evidence of associated degenerative disk disease at the level of involvement. Histopathologic sections in three cases of type 1 change demonstrated disruption and fissuring of the end plates and vascularized fibrous tissue, while in three cases of type 2 change they demonstrated yellow marrow replacement. In addition, 16 patients with end-plate changes documented with MR were studied longitudinally. Type 1 changes in five of six patients converted to a type 2 pattern in 14 months to 3 years. Type 2 changes in ten patients remained stable over a 2-3-year period. These signal intensity changes appear to reflect a spectrum of vertebral body marrow changes associated with degenerative disk disease.
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                Author and article information

                Journal
                J Pain Res
                J Pain Res
                Journal of Pain Research
                Journal of Pain Research
                Dove Medical Press
                1178-7090
                2018
                26 October 2018
                : 11
                : 2617-2623
                Affiliations
                [1 ]Department of Orthopedics Surgery, Tianjin Medical University General Hospital, Heping District, Tianjin 300052, People’s Republic of China, xueyuanzyy@ 123456163.com
                [2 ]Department of Orthopedics Surgery, Tianjin Hospital, Hexi District, Tianjin 300211, People’s Republic of China
                Author notes
                Correspondence: Yuan Xue, Department of Orthopedics Surgery, Tianjin Medical University General Hospital, No. 154 Anshan Road, Heping District, Tianjin 300052, People’s Republic of China, Tel +86 22 6081 4688, Fax +86 22 2721 9052, Email xueyuanzyy@ 123456163.com
                Article
                jpr-11-2617
                10.2147/JPR.S172953
                6209067
                30464580
                673e381f-41d0-4d88-9b63-0a8ae2bea27d
                © 2018 Zhou et al. This work is published and licensed by Dove Medical Press Limited

                The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.

                History
                Categories
                Original Research

                Anesthesiology & Pain management
                anterior cervical discectomy and fusion,cervical spondylotic myelopathy,axial symptoms,segmental angle,modic changes

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