Surgical options and clinical outcomes in patients of lumbar disc herniation with Modic changes

Abstract

OBJECTIVE:

To retropspectively evaluate medium and long-term outcomes of conventional fenestration discectomy versus posterior lumbar interbody fusion in lumbar disc herniationwith Modic changes.

METHODS:

From January 2002 to January 2007, a total of 486 patients of lumbar discherniation with Modic changes were analyzed retrospectively. They were divided into fenestration group (n = 215) and fusion group (n = 271) according to the operative approaches. The scores of Oswestry disability index (ODI) and visual analog scale (VAS) pre-and post-operative 3, 6, 12 month and annually were recorded and analyzed.

RESULTS:

All of them had complete records during a mean follow-up period of 88.9 (60-120) months. At the end of the latest follow-up, all symptoms were relieved postoperatively. Significantly difference existed in the improvement rate of back pain VAS between two groups (77.9% vs 68.0%). In the fenestration group, the improvement rate of VAS (back pain) of Modic type I I was better than that of Modic type I (72.8% vs 64.9%). And the difference was statistically significant. For those with Modic type I changes, the improvement rate of ODI and VAS (back pain) of the fusion group were better than those of the fenestration group (78.3% vs 70.4% and 77.4% vs 64.9%). And the differences were statistically significant (P < 0.05).

CONCLUSION:

The patients with Modic I and II changes were recommended to undergolumbar fusion and undergo fenestration discectomy respectively.

PMID:

 

24417988

 

[PubMed - in process]