A study on the cervical spondylotic myelopathy treated by anterior cervical diskectomy and fusion in accordance with Modic changes with a 2-year minimum follow-up

BACKGROUND: The aim of this research is to analyze the influence of Modic types on the clinical results of cervical spondylotic myelopathy treated by anterior cervical diskectomy and fusion. METHODS: A total of 106 patients with a mean age of 55.8 ± 6.5 years were included in this study. Patients with Modic changes were retrospectively reviewed. In this study, 23 patients were classified as Modic-1, 39 patients were classified as Modic-2, and 44 patients were classified as Modic-0. Clinical evaluations were performed preoperatively and repeated at 3, 6, 12, and 24 months after operation. RESULTS: In this study, all patients were followed up for a mean period of 30.2 months (range, from 24 to 36 months). Significant clinical improvement (P < 0.05) was observed in Japanese Orthopaedic Association (JOA) score and axial symptoms between the preoperative evaluation and the final follow-up. Comparing the result of mean JOA score after anterior cervical diskectomy and fusion (ACDF) in the Modic-1 group and other groups, statistically significant differences could be found at 12 months after surgery (P < 0.05). Comparing the outcome visual analog scale (VAS) of axial symptoms among different groups after ACDF, patients with Modic-1 changes showed significantly lower VAS of axial symptoms postoperatively (P < 0.05). CONCLUSION: After anterior cervical diskectomy and fusion, both Modic-1 and Modic-2 groups showed excellent clinical outcomes over a 2-year follow-up. Better clinical results were achieved in patients with Modic-1 changes compared to the group of patients with Modic-2 and Modic-0 changes on magnetic resonance images.