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Characteristics of Vertebral Endplate Signal (Modic) Changes in Cervical Spine and Its Relation with Cervical Degeneration

Author: LiJiGang
Tutor: YangHuiLin
School: Suzhou University
Course: Surgery
Keywords: Cervical spine Endplate Disc degeneration Modic change Magnetic resonance imaging
CLC: R687.3
Type: Master's thesis
Year: 2011
Downloads: 40
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Abstract


Objective: To report on the prevalence, types, distribution of Modic changes and its related factors with cervical degeneration found for the cervical spine.Methods: In the year 2009, 1187 selected cervical spine MRI and X-ray were viewed, including 582 male and 605 female, Age ranges from 20 to 89, mean age of male was 45.7, female 46.3 years.The presence or absence of Modic changes, then the specific Modic type according to Modic classification criteria and the precise vertebral levels and location of these changes were recorded. The grade of disc degeneration was assessed according to the Pfirrmann system on MRI T2WI images. Cervical lordosis was measured as the angle formed by a line parallel to the posterior surface of the body of C2 and a line parallel to the posterior surface of the body of C7.Height loss is assessed on lateral radiographs, comparing the middle disc height of the target level to the middle disc height of a normal adjacent level. All the images were double-blindly analyzed by two doctors independently. Kappa statistic was used to assess the intra and interobserver reliability.Logistic regression ananlysis was used for the evaluation of Modic change on cervical degeneration.Results: Among 7122 intervertebral disc of 1187 cases of patients, 126 patients and 142 intervertebral discs were involved with Modic changes. 33 cases and 34 discs were type I; 78cases and 93 discs were typeⅡ; 15 cases and 15 discs were type III. Totally, 119 changes involved the upper endplate, 114 involved the lower endplate; 93 changes in the anterior 1/2 of the endplate,140 changes in the posterior 1/2 according to the location of Modic changes in the endplate.The C5/6 vertebral levels were the most commonly involved with 59(4.97%) Modic changes, the other levels were C2/3 disc for 0(0%), C3/4 for 16(1.35%), C4/5 for 34(2.86%),C6/7for 23(2.27%), C7/T1 for 6 (0.51%) endplate changes respectively.There was no sex difference in the prevalence and distribution of the Modic changes in this study involving the cervical spine, with 9.42% of the Modic changes seen in female patients, 11.86% in male patients.There were significant association in the incidence between different age groups with the incidence of 1.35% in group 20～29, 2.98% in group 30～39, 9.54% in 40～49, and 14.87% in group 50～59, 13.19% in group 60～69, 15.05% in group 70～79, 13.79% in group 80～89.There was significant association between the grade of degeneration and prsence of Modic changes, with the incidence of 0% in gradeⅠdisc degeneration, 0.18% in gradeⅡ, 0.89% in gradeⅢ, 9.25% in gradeⅣ, 34.38% in gradeⅤ. There were also significant association between cervical curve,disc height and the prence of Modic change. Logistic regression ananlysis showed: Y=-10.2257-0.0323 A-0.335 D+16.729 S+ 0.3252 C+0.4711 HConclusion: Modic changes are observed in the cervical spine, with the C5/6 level being the most commonly involved. TtypeⅡis the most, typeⅢis the least. They are far more common in the posterior area of the endplate.Modic changes is significantly correlated with ages,grade of disc degeneration, disc level, disc height and cervical curve. Modic change may be the manifestation of sever disc degneration.

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CLC: > Medicine, health > Surgery > Orthopaedic Surgery ( movement system diseases,orthopedic surgery ) > Orthopedic surgery and surgery > Bone surgery
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