title: Correlation Analysis Between Modic Change of Cervical Vertebrae and Intramedullary High Signal Intensity.
abstract: OBJECTIVE
  Clinical studies have shown that endplate Modic change in the cervical spine and intramedullary high signal intensity often occurs simultaneously. We aimed to investigate whether there is a correlation between Modic change and intramedullary high signal intensity, and to explore the possible risk factors.
  
  
  METHODS
  In total, 133 patients with cervical spondylotic myelopathy treated at the First Affiliated Hospital of Nanjing Medical University between May 2009 and March 2013 were enrolled in the study. Preoperative cervical magnetic resonance imaging and radiographs in hyperextension and hyperflexion were analyzed. With regard to magnetic resonance imaging, all patients were classified into groups according to Modic change types and intramedullary high signal intensity; the ratio of spinal cord compression reflected the degree of spinal stenosis. For plain radiographs, total range of motion (ROM) and segmental ROM of the cervical vertebrae were measured.
  
  
  RESULTS
  Modic change of the cervical vertebral endplate and intramedullary high signal intensity demonstrated a significantly positive correlation. In patients with Modic change and intramedullary high signal intensity, the segmental angle of motion of the cervical vertebrae in hyperextension, cervical segmental ROM, and ratio of spinal cord compression were significantly higher than in patients without Modic change and intramedullary high signal intensity.
  
  
  CONCLUSIONS
  The occurrence of Modic change and intramedullary high signal intensity are related to cervical instability and spinal canal stenosis. Severe disc protrusion may cause an increase of ROM in cervical hyperextension. Such patients are more prone to Modic change of the cervical vertebral endplate and intramedullary high signal intensity.
authors.affiliation: *Orthopaedic Department, the First Affiliated Hospital of Nanjing Medical University †Huai'an First People's Hospital, Orthopaedic, Jiangsu, China.
authors.forename: Hao
authors.initials: H
authors.lastname: Zhou
authors.forename: Jin
authors.initials: J
authors.lastname: Fan
authors.forename: Peng
authors.initials: P
authors.lastname: Sun
authors.forename: Wei
authors.initials: W
authors.lastname: Zhou
authors.forename: Qingqing
authors.initials: Q
authors.lastname: Li
authors.forename: Lipeng
authors.initials: L
authors.lastname: Yu
authors.forename: Guoyong
authors.initials: G
authors.lastname: Yin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012815:Signal Processing, Computer-Assisted; D013223:Statistics as Topic