Is the bone fusion affected by Modic-2 changes in single-level anterior cervical discectomy and fusion?
Is the bone fusion affected by Modic-2 changes in single-level anterior cervical discectomy and fusion?
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单节段颈椎前路椎间盘切除融合术中的Modic-2变化是否会影响骨融合？
DOI：
10.1097/md.0000000000018597
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发表时间：
2020-01-01
期刊：
影响因子：
1.6
通讯作者：
Wu, Tingkui
中科院分区：
文献类型：
--
作者：
Huang, Kangkang;Hong, Ying;Wu, Tingkui
探讨Modic变化（MCs）对零侧位种植体（Zero-P种植体系统）单节段前路颈椎椎间盘切除术融合（ACDF）后骨融合的影响。2014年11月至2017年11月，共116例采用Zero-P种植体行单节段ACDF的患者，根据MRI是否显示2型MCs （MC2）或无MCs分为两组（分别为MC2组和NMC组）。NMC组92例（79.3%），MC2组24例（20.7%）。回顾性评估两组患者术前、术后3、6、12个月及最终随访的临床结果和融合率。与术前比较，NMC组和MC2组患者颈痛的JOA评分和视觉模拟评分均有显著提高（P < 0.05）。两组患者JOA、VAS评分差异无统计学意义（P < 0.05）。NMC组和MC2组术后3、6、12个月及最终随访的融合率分别为33.7%和12.5%、77.2%和54.2%、89.1%和87.5%、97.8%和95.8%。术后3、6个月MC2组融合率明显低于NMC组（P < 0.05）。MC2的存在不影响临床结果，但延迟了使用Zero-P种植体系统ACDF后的融合时间。证据等级为三级。
Abstract To explore the impact of Modic changes (MCs) on bone fusion after single-level anterior cervical discectomy and fusion (ACDF) with a zero-profile implant (the Zero-P implant system). From November 2014 to November 2017, a total of 116 patients who underwent single-level ACDF with the Zero-P implant were divided into two groups according to MRI showing type 2 MCs (MC2) or no MCs (i.e., the MC2 group and the NMC group, respectively). A total of 92 (79.3%) patients were classified into the NMC group, and 24 (20.7%) patients were classified into the MC2 group. The clinical outcomes and fusion rates were retrospectively evaluated between the 2 groups preoperatively and postoperatively at 3, 6, and 12 months, and the final follow-up. The Japanese Orthopedic Association (JOA) scores and the visual analogue scale (VAS) scores of neck pain were significantly improved compared to the preoperative scores in both the NMC and MC2 groups (P < .05). However, there were no differences in JOA or VAS scores between the 2 groups (P > .05). The fusion rates of the NMC and MC2 groups at 3, 6, and 12 months postoperatively, and the final follow-up were 33.7% and 12.5%, 77.2% and 54.2%, 89.1% and 87.5%, and 97.8% and 95.8%, respectively. The fusion rates were significantly lower at 3 and 6 months after surgery in the MC2 group than in the NMC group (P < .05). The presence of MC2 did not affect the clinical outcome but delayed the fusion time following ACDF with the Zero-P implant system. Level of Evidence is Level 3.