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. 2020 Jun;17(2):443-452.
doi: 10.14245/ns.2040076.038. Epub 2020 Jun 30.

Relationship Between Endplate Defects, Modic Change, Facet Joint Degeneration, and Disc Degeneration of Cervical Spine

Su-Hun Lee  1   2 , Dong Wuk Son  1   2 , Jun-Seok Lee  1   2 , Soon-Ki Sung  1   2 , Sang Weon Lee  1   2 , Geun Sung Song  1   2
Affiliations

Relationship Between Endplate Defects, Modic Change, Facet Joint Degeneration, and Disc Degeneration of Cervical Spine

Su-Hun Lee et al. Neurospine. 2020 Jun.

Abstract

Objective: The ''disc degeneration precedes facet joint osteoarthritis'' hypothesis and multidimensional analysis were actively discussed in lumbar spine. However, in cervical spine degeneration, the multifactorial analyzes of disc degeneration (DD), Modic changes (Mcs), facet degeneration, and endplate degeneration (ED) is still limited. In this cross-sectional study, we aimed to analyze the prevalence and interrelationship of cervical DD parameters.

Methods: We retrospectively recruited 62 patients aged between 60 and 70 years. The disc height, segmental angle, ossified posterior longitudinal ligament (OPLL), ED, facet joint degeneration (FD), uncovertebral joint degeneration (UD), DD, spinal stenosis (SS), Mc, and cord signal change (CS) were evaluated using a previously well-known grading system.

Results: The prevalence of cervical degenerative parameters were DD (grade 1, 1.2%; grade 2, 13.3%; grade 3, 54.8%; grade 4, 19.0%; grade 5, 11.7%), OPLL (26.2%), SS (grade 0, 7.7%; grade 1, 42.3%; grade 2, 26.2%; grade 3, 23.8%), UD (39.1%), ED (normal, 69.0%; focal defect, 9.7%; corner defect, 11.7%; erosion, 6.9%; sclerosis, 2.8%), and FD (normal, 48.8%; narrowing, 27.0%; hypertrophied, 24.2%). The interrelationship of degenerative parameters showed close relation between UD, SS, DD, OPLL, Mc. ED, and CS has partial relation with degenerative finding. FD only has relation with UD, and Mc.

Conclusion: Our results may indicate that FD is a degeneration that occurs independently, rather than as a result of other degenerative factors.

Keywords: Cross-sectional studies; Intervertebral disc degeneration; Spinal stenosis; Spondylosis; Zygapophyseal joint.

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Conflict of interest statement

The authors have nothing to disclose.

Figures

Fig. 1.
Fig. 1.
Measurement methods for X-ray parameters: (A) segmental angle at flexion position, (B) disc height and segmental angle at neutral position, and (C) segmental angle at extension position. SA, segmental angle.
Fig. 2.
Fig. 2.
Analysis of variance study for disc height, segmental angle (SA), SA range of motion (SA ROM), and spinal stenosis, disc degeneration, facet joint degeneration, and endplate degeneration grade.
See this image and copyright information in PMC

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