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Purpose: The cervical segmental instability often occurs simultaneously with Modic changes (MCs). However, it is unknown whether there is a relation between the two diseases. The aim of this study was to evaluate the relationship between MCs and cervical segmental instability, cervical curvature and range of motion (ROM) in the cervical spine., Methods: A total of 464 patients with neck pain or cervical neurologic symptoms who underwent imaging examination were analyzed retrospectively. Based on MRI imaging cervical MCs were diagnosed, and patients were divided into with or without MCs groups. The cervical curvature and range of motion were measured. We compared the incidence of cervical instability, cervical curvature and ROM between the two group patients and their relationships with MCs were studied. Logistic regression was used to study the risk factors associated with MCs., Results: MCs were observed in 94 of 464 patients and 122 of total 2320 cervical segments and were most frequent at C5-6 segment. The incidence of the cervical instability was significantly higher in patients with MCs than those without MCs at cervical level C3-7. In addition, cervical curvature and ROM in patients with MCs were less than those without MCs. Logistic regression analysis showed that the occurrence of cervical spine instability, less cervical curvature and ROM were risk factors for MCs., Conclusions: Patients with MCs were prone to have cervical instability at the same cervical level and may have a higher possibility of less cervical curvature and ROM.

BACKGROUND AND OBJECTIVE: Cervical spondylotic amyotrophy (CSA) is a relatively rare disorder. This study was conducted to elucidate the prognosis of proximal-type CSA after anterior decompressive surgery by evaluating clinical factors and imaging findings. METHODS: Anterior decompressive surgery was performed in 40 patients with proximal-type CSA between March 2000 and December 2011. Patients were classified into 2 categories based on axial T2-weighted magnetic resonance imaging (MRI) findings: "nerve root compression (NRC)", with nerve root compressed at the intervertebral foramen, and "spinal cord compression (SCC)" with spinal cord compressed at the medial or paramedial site of spinal canal. Manual muscle testing (MMT) was used to evaluate the surgical effect. Scapular, deltoid, and biceps brachii muscles of the affected side were tested and the sum scores were calculated. Clinical factors and imaging findings, such as age, duration of disease, preoperative MMT grade, number of affected levels and signal intensity changes of spinal cord, were collected to analyze prognostic factors.RESULTS: After anterior decompressive surgery, 30 patients (75%) showed an improvement. NRC was observed in 6 patients and SCC in the rest 34 patients based on MRI findings. All patients (100%) with NRC had an improvement, while only 24 patients (70.6%) with SCC improved. In patients with SCC, there was a significant difference in duration of disease between patients who had an improvement and those who had not (P< 0.01).CONCLUSIONS: Anterior decompressive surgery is effective in the treatment of most patients with CSA. NRC on MRI may indicate a good surgical outcome. In patients with SCC, a long duration of disease is a risk factor for poor prognosis. [ABSTRACT FROM AUTHOR]