• Olga Leonova, Evgenii Baykov, Abdugafur Sanginov, and Aleksandr Krutko.
• Neurosurgery Department, Novosibirsk Research Institute of Traumatology and Orthopaedics (NRITO) n.a.Ya.L.Tsivyan, Novosibirsk, Russia.
• Spine. 2021 Sep 15; 46 (18): 1234-1240.

Study DesignLongitudinal study of cervical MR in patients with degenerative disc disease (DDD).ObjectiveTo evaluate the evolution of the degenerative changes in the C2-D1 cervical segments and to assess the association magnetic resonance imaging (MRI) parameters with clinical symptoms after surgical treatment in patients with DDD.Summary Of Background DataThe evolution of degenerative changes in the cervical spine is poorly understood. Endplate defects can be of great importance in progressive disc degeneration (DD). Clarification of this predictor may be important in determining the treatment tactics in patients with DDD.MethodsThe study included patients who had 2-years' follow-up after cervical fusion for spondylotic radiculo- with/without myelopathy. Demographic data (age, sex, surgical data) were assessed; clinical data (visual analogue scale [VAS] neck, VAS arm, Neck Disability Index [NDI]) and cervical MRI (DD grades by Pfirrmann, Modic changes (MC), total endplate scores (TEPS) were compared to preoperative data.ResultsThe median follow-up term was 26.5 (18.9-33.1) months. All patients reported a decrease neck pain and arm pain at follow-up (P < 0.001). There was observed the change in MC types (P < 0.001) and an increase of TEPS (P < 0.05). 71.7% discs remained unchanged during the follow-up, but a significant number of discs went from Grade 2 to Grade 3 and from Grade 3 to Grade 4 by Pfirrmann (P < 0.001). Clinical scores (VAS neck, VAS arm, NDI) had no correlation with MRI changes (P > 0.05). DD was associated with TEPS (odds ratio [OR] 2.05-5.47, P < 0.05) and patients' age (OR 1.11-2.33, P < 0.05) at all cervical levels; with MC types, but only at C4-C5 and C6-C7 levels (OR = 2.91 and 2.79, respectively, P < 0.05). Receiver-operating characteristic analysis showed a TEPS threshold value of 7, above which the probability of DD significantly higher.ConclusionDuring 2 years' follow-up the significant increase of DD grades by Pfirrmann was observed at C4-C6 levels (P < 0.001). A significant association DD with TEPS and age at all cervical levels was determined.Level of Evidence: 3.Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.

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