Influence of Modic Changes on Cervical Fusion After Single-level Anterior Cervical Discectomy and Fusion.
Abstract Objective: The purpose of this study was to investigate the relationship between cervical Modic changes and cervical fusion. Methods: This study enrolled 222 patients who underwent single-level anterior cervical discectomy and fusion(ACDF) surgical treatment between April 2014 and July 2019 at our institution, xingtai mining group general. All patients were followed up for more than 1 year after surgery. According to the presence or absence of Modic changes, 66 cases were divided into group A with Modic changes and 156 cases in group B without Modic changes. The pathological changes of cervical spine Modic were divided into 3 stages: Type 1 (inflammation or edema), manifested as endplate and subendplate The tissue is replaced by fibrovascular tissue, accompanied by granulation tissue ingrowth, bone marrow and trabecular edema; type 2 (fatty stage or yellow bone marrow stage), showing the corresponding histopathological changes as red bone marrow transition between trabecular bone It is yellow bone marrow with a large amount of adipose tissue deposition; Type 3 (osteosclerosis stage), which manifests as the endplate and the sub-endplate tissue hyperplasia and hardening into bone tissue. The bone healing process is roughly divided into the organizing period of hematoma formation; the original callus formation period; and the plastic period of callus transformation. According to Modic I, II, and III classifications, sub-groups are carried out in sequence: A1, A2, A3, and the differences in fusion between the groups during follow-up are compared. Results: There was a statistically significant difference between the two groups at the 3 months (p=0.004) and 6 months (p=0.044) follow-up of group A and group B, and there was no statistical difference between the two groups at the last follow-up (p=0.43) Significance; the three groups of A1, A2, and A3 were followed up for 3 months (p=0.007) and 6 months (p=0.002). The difference between the three groups was statistically significant, and the difference between the three groups at the last follow-up (p=0.092) No statistical significance. Conclusion: The fusion rate of patients with cervical Modic changes in the early and middle postoperative period is lower than that of normal cervical patients, and the fusion effect of Modic type I patients is better than that of Moidc II and III. However, the last follow-up showed that all patients have achieved fusion, that is, cervical Modic changes have a positive effect. The patient's fusion rate has no effect.