title: The Impact of Modic-2 changes on the clinical outcomes of single-level anterior cervical discectomy and fusion.
abstract: OBJECTIVE
  The purpose of the study was to explore the impact of Modic-2 changes on the clinical outcomes of single-level anterior cervical discectomy and fusion.
  
  
  METHODS
  This study retrospectively reviewed the medical records of 35 ACDF patients with Modic-2 changes at adjacent level (Group A) and 213 patients without Modic-2 changes at adjacent level (Group B). Clinical and radiographic evaluations were performed preoperatively and repeated at 3, 6, 12, and 60 months after surgery.
  
  
  RESULTS
  All patients were followed up for an average of 60 months. The clinical improvements in terms of NDI and JOA scores were achieved in both groups (P < 0.05), and no significant differences were found between the two groups (P > 0.05). The radiologic review demonstrated ASD was proven in 9 patients in Group A and 52 patients in Group B. A significant increase in ROM at the adjacent segments after surgery was observed in both groups (P < 0.05). No significant differences in adjacent segment ROM and DH were observed between two groups (P > 0.05). Comparing the outcome VAS of axial symptoms with Group A after surgery, patients in the Group B reported significantly lower VAS of axial symptoms at 1-year follow-up (P < 0.05). There were no significant differences between the two groups at the final follow-up (P > 0.05).
  
  
  CONCLUSIONS
  Modic-2 changes at adjacent level at baseline does not affect fusion rate or clinical outcome based on functional status but could negatively impact axial symptoms intensity and ASD, compared to patients without Modic-2 changes.
authors.affiliation: Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, 050051, People's Republic of China. ljlyqbwin2010@yeah.net.|The Key Laboratory of Orthopedic Biomechanics of Hebei Province, The Third Hospital of Hebei Medical University, Shijiazhuang, 050051, People's Republic of China. ljlyqbwin2010@yeah.net.
authors.forename: Jia
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, 050051, People's Republic of China.|The Key Laboratory of Orthopedic Biomechanics of Hebei Province, The Third Hospital of Hebei Medical University, Shijiazhuang, 050051, People's Republic of China.
authors.forename: Tao
authors.initials: T
authors.lastname: Lei
authors.affiliation: Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, 050051, People's Republic of China.|The Key Laboratory of Orthopedic Biomechanics of Hebei Province, The Third Hospital of Hebei Medical University, Shijiazhuang, 050051, People's Republic of China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Shen
mesh_terms: D000328:Adult; D000368:Aged; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*; D017586:Diskectomy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007403:Intervertebral Disc / Q000601:surgery*; D055959:Intervertebral Disc Degeneration / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011859:Radiography; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D013123:Spinal Fusion / Q000379:methods*; D016896:Treatment Outcome
keywords: Adjacent segment degeneration; Anterior cervical discetomy and fusion; Axial symptoms; Modic-2 changes