Aske Foldbjerg Laustsen1, Rachid Bech-Azeddine2. 1. Department of Rheumatology and Spine Diseases, Rigshospitalet Glostrup, Nordre Ringvej 57, 2600, Glostrup, Denmark. 2. Department of Rheumatology and Spine Diseases, Rigshospitalet Glostrup, Nordre Ringvej 57, 2600, Glostrup, Denmark. rachid.bech-azeddine@regionh.dk.
Abstract
PURPOSE: To provide a systematic literature review of the impact of preoperative Modic changes (MCs) on the clinical outcome following lumbar spine surgery for degenerative lumbar spine disease. METHODS: A PubMed search until 31 October 2015 was performed to identify publications correlating preoperative MC with clinical outcome in patients undergoing spine surgery. RESULTS: Inclusion criteria were met by 14 articles (7 prospective and 7 retrospective studies) representing a total of 1652 surgical patients, of which at least 804 (>49 %) showed MC. Of the 14 publications, 6 concerned discectomy (n = 607), 1 fusion versus discectomy (n = 91), 3 fusion surgery (n = 454), and 4 total disc replacement (TDR, n = 500). A trend toward less improvement in low back pain or Oswestry Disability Index score was found in the discectomy studies, and a trend toward increased improvement was demonstrated in the TDR studies when MC was present preoperatively. The fusion studies were of low evidence, and showed conflicting results. CONCLUSION: Preoperative MC showed a trend toward a negative correlation with clinical improvement in patients undergoing discectomy for LDH and a positive correlation with clinical improvement in patients undergoing TDR for degenerative disc disease. However, it is questionable whether the differences surpass the minimal clinically important difference (MCID). In patients undergoing fusion surgery, there was insufficient evidence to draw any conclusions. Future studies should include a larger patient material, focus on MCID, and include known confounding factors of the clinical outcome of spine surgery in the analysis.
PURPOSE: To provide a systematic literature review of the impact of preoperative Modic changes (MCs) on the clinical outcome following lumbar spine surgery for degenerative lumbar spine disease. METHODS: A PubMed search until 31 October 2015 was performed to identify publications correlating preoperative MC with clinical outcome in patients undergoing spine surgery. RESULTS: Inclusion criteria were met by 14 articles (7 prospective and 7 retrospective studies) representing a total of 1652 surgical patients, of which at least 804 (>49 %) showed MC. Of the 14 publications, 6 concerned discectomy (n = 607), 1 fusion versus discectomy (n = 91), 3 fusion surgery (n = 454), and 4 total disc replacement (TDR, n = 500). A trend toward less improvement in low back pain or Oswestry Disability Index score was found in the discectomy studies, and a trend toward increased improvement was demonstrated in the TDR studies when MC was present preoperatively. The fusion studies were of low evidence, and showed conflicting results. CONCLUSION: Preoperative MC showed a trend toward a negative correlation with clinical improvement in patients undergoing discectomy for LDH and a positive correlation with clinical improvement in patients undergoing TDR for degenerative disc disease. However, it is questionable whether the differences surpass the minimal clinically important difference (MCID). In patients undergoing fusion surgery, there was insufficient evidence to draw any conclusions. Future studies should include a larger patient material, focus on MCID, and include known confounding factors of the clinical outcome of spine surgery in the analysis.
Authors: Ralph Rahme; Ronald Moussa; Rabih Bou-Nassif; Joseph Maarrawi; Tony Rizk; Georges Nohra; Elie Samaha; Nabil Okais Journal: Can J Neurol Sci Date: 2011-05 Impact factor: 2.104
Authors: Tue Secher Jensen; Jaro Karppinen; Joan S Sorensen; Jaakko Niinimäki; Charlotte Leboeuf-Yde Journal: Eur Spine J Date: 2008-09-12 Impact factor: 3.134
Authors: Juhani H Määttä; Sam Wadge; Alex MacGregor; Jaro Karppinen; Frances M K Williams Journal: Spine (Phila Pa 1976) Date: 2015-08-01 Impact factor: 3.468
Authors: Scott L Parker; Stephen K Mendenhall; Saniya S Godil; Priya Sivasubramanian; Kevin Cahill; John Ziewacz; Matthew J McGirt Journal: Clin Orthop Relat Res Date: 2015-06 Impact factor: 4.176
Authors: Hanne B Albert; Andrew M Briggs; Peter Kent; Andreas Byrhagen; Christian Hansen; Karina Kjaergaard Journal: Eur Spine J Date: 2011-05-05 Impact factor: 3.134
Authors: Tharindu De Silva; S Swaroop Vedula; Alexander Perdomo-Pantoja; Rohan Vijayan; Sophia A Doerr; Ali Uneri; Runze Han; Michael D Ketcha; Richard L Skolasky; Timothy Witham; Nicholas Theodore; Jeffrey H Siewerdsen Journal: J Med Imaging (Bellingham) Date: 2020-02-18
Authors: Anja Tschugg; Sara Lener; Sebastian Hartmann; Matthias Wildauer; Wolfgang N Löscher; Sabrina Neururer; Claudius Thomé Journal: Neurosurg Rev Date: 2017-01-13 Impact factor: 3.042