Abstract
Introduction
There is a controversy regarding the prognostic role of Modic changes (MC's) for lumbar discectomy. The aim of this study was to evaluate whether Modic changes affect the results of lumbar discectomy 1 year after surgery.
Materials and Methods
The study population consisted of 180 sciatica patients from Northern and Eastern Finland who underwent discectomy. Pain intensity (low back and leg pain) and disability on Oswestry Disability Index (ODI) were evaluated preoperatively and 1 year after surgery. Lumbar MC's on magnetic resonance imaging were classified into: “No MC,” “Type I” (Type I or I/II), and “Type II” (Type II, II/III, or III). The analyses were performed using the analysis of covariance (ANCOVA) with adjustments for age, gender, and disk degeneration (DD) sum score.
Results
At baseline, 83 (46%) patients had MC's. Of MC's, 33% were Type I. Patients with MC's were older, more likely female and had a higher degree of DD than patients without MC's. Patients with Type I MC's had smaller improvement in ODI than patients with No MC (p = 0.045) or Type II MC's (p = 0.037). The improvements in low back and leg pain were similar than in ODI but the differences were not significant.
Conclusion
Type I MC's indicated a poorer prognosis of lumbar discectomy. The previous contradictory results may be due to smaller study sample sizes. Patients with ‘Type I’ MC's had smaller disability improvement than patients without MC's or with Type II MC's 1 year after discectomy.
Yes
None declared