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The Impact of Modic-2 changes on the clinical outcomes of single-level anterior cervical discectomy and fusion

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The purpose of the study was to explore the impact of Modic-2 changes on the clinical outcomes of single-level anterior cervical discectomy and fusion.


This study retrospectively reviewed the medical records of 35 ACDF patients with Modic-2 changes at adjacent level (Group A) and 213 patients without Modic-2 changes at adjacent level (Group B). Clinical and radiographic evaluations were performed preoperatively and repeated at 3, 6, 12, and 60 months after surgery.


All patients were followed up for an average of 60 months. The clinical improvements in terms of NDI and JOA scores were achieved in both groups (P < 0.05), and no significant differences were found between the two groups (P > 0.05). The radiologic review demonstrated ASD was proven in 9 patients in Group A and 52 patients in Group B. A significant increase in ROM at the adjacent segments after surgery was observed in both groups (P < 0.05). No significant differences in adjacent segment ROM and DH were observed between two groups (P > 0.05). Comparing the outcome VAS of axial symptoms with Group A after surgery, patients in the Group B reported significantly lower VAS of axial symptoms at 1-year follow-up (P < 0.05). There were no significant differences between the two groups at the final follow-up (P > 0.05).


Modic-2 changes at adjacent level at baseline does not affect fusion rate or clinical outcome based on functional status but could negatively impact axial symptoms intensity and ASD, compared to patients without Modic-2 changes.

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Correspondence to Jia Li.

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All authors have read and contributed to the submitted manuscript and there is no conflict of interest among the authors.

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This material has not been published and is not under consideration elsewhere. This study receives no financial support. The Impact of Modic-2 changes on the clinical outcomes of single-level anterior cervical discectomy and fusion.

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Li, J., Lei, T. & Shen, Y. The Impact of Modic-2 changes on the clinical outcomes of single-level anterior cervical discectomy and fusion. Eur Spine J 24, 2936–2940 (2015).

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