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      Frequency of Vertebral Endplate Modic Changes in Patients with Unstable Lumbar Spine and Its Effect on Surgical Outcome

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          Abstract

          Study Design

          Prospective cohort study.

          Purpose

          In this study, we investigated the frequency of vertebral endplate Modic changes (MCs) and their effects on surgical outcomes in patients with unstable lumbar spines.

          Overview of Literature

          Signal changes in endplates have been classified into three types by Modic. The prognostic role of MCs has been investigated in various spinal disorders.

          Methods

          A series of 70 patients with clinical and radiographic unstable lumbar spine were included in the study. Endplate signal intensity was determined according to Modic classification. All patients underwent instrumented posterolateral fusion. Functional evaluation was made using the visual analog scale (VAS) and Oswestry disability index (ODI).

          Results

          Eighteen patients (26%) had normal endplate intensity, 31 patients (44%) had MC type I, 20 patients (28%) had MC type II, and one patient (1.4%) had MC type III. Pain level VAS and ODI decreased significantly from the preoperative evaluation to the six-month and one-year postoperative evaluations. The surgical outcome (VAS and ODI) was not significantly different between the various types of MC.

          Conclusions

          Posterolateral fusion is an effective treatment in patients with unstable lumbar spines. MC do not have a significant effect on the surgical outcome of these patients.

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          Most cited references27

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          Imaging of degenerative disk disease.

          J. Carter, M T Modic, T Masaryk … (1988)
          Article 0 comments Cited 188 times – based on 0 reviews     Review now
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            Prevalence and distribution of intervertebral disc degeneration over the entire spine in a population-based cohort: the Wakayama Spine Study.

            M Teraguchi, N Yoshimura, H Hashizume … (2014)
            The purposes of this study were to investigate the prevalence and distribution of intervertebral disc degeneration (DD) over the entire spine using magnetic resonance imaging (MRI), and to examine the factors and symptoms potentially associated with DD.
            Article 0 comments Cited 150 times – based on 0 reviews     Review now
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              Vertebral endplate signal changes (Modic change): a systematic literature review of prevalence and association with non-specific low back pain.

              Joan Sorensen, Jaro Karppinen, Jaakko Niinimäki … (2008)
              The prevalence of "vertebral endplate signal changes" (VESC) and its association with low back pain (LBP) varies greatly between studies. This wide range in reported prevalence rates and associations with LBP could be explained by differences in the definitions of VESC, LBP, or study sample. The objectives of this systematic critical review were to investigate the current literature in relation to the prevalence of VESC (including Modic changes) and the association with non-specific low back pain (LBP). The MEDLINE, EMBASE, and SveMED databases were searched for the period 1984 to November 2007. Included were the articles that reported the prevalence of VESC in non-LBP, general, working, and clinical populations. Included were also articles that investigated the association between VESC and LBP. Articles on specific LBP conditions were excluded. A checklist including items related to the research questions and overall quality of the articles was used for data collection and quality assessment. The reported prevalence rates were studied in relation to mean age, gender, study sample, year of publication, country of study, and quality score. To estimate the association between VESC and LBP, 2 x 2 tables were created to calculate the exact odds ratio (OR) with 95% confidence intervals. Eighty-two study samples from 77 original articles were identified and included in the analysis. The median of the reported prevalence rates for any type of VESC was 43% in patients with non-specific LBP and/or sciatica and 6% in non-clinical populations. The prevalence was positively associated with age and was negatively associated with the overall quality of the studies. A positive association between VESC and non-specific LBP was found in seven of ten studies from the general, working, and clinical populations with ORs from 2.0 to 19.9. This systematic review shows that VESC is a common MRI-finding in patients with non-specific LBP and is associated with pain. However, it should be noted that VESC may be present in individuals without LBP.
              Article 0 comments Cited 132 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Asian Spine J
                Journal ID (iso-abbrev): Asian Spine J
                Journal ID (publisher-id): ASJ
                Title: Asian Spine Journal
                Publisher: Korean Society of Spine Surgery
                ISSN (Print): 1976-1902
                ISSN (Electronic): 1976-7846
                Publication date (Print): October 2015
                Publication date (Electronic): 22 September 2015
                Volume: 9
                Issue: 5
                Pages: 737-740
                Affiliations
                Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
                Author notes
                Corresponding author: Morteza Faghih Jouibari. Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Jalal Al Ahmad Street, Amir Abad Avenue, Tehran, Iran. Tel: +98-21-8822-0040, Fax: +98-21-8822-0040, mortezafaghihj@ 123456yahoo.com
                Article
                DOI: 10.4184/asj.2015.9.5.737
                PMC ID: 4591445
                SO-VID: d8951026-a26f-490b-9aa8-80c2c59918e3
                Copyright © Copyright © 2015 by Korean Society of Spine Surgery
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 25 January 2015
                Date revision received : 22 February 2015
                Date accepted : 07 March 2015
                Categories
                Subject: Clinical Study

                ScienceOpen disciplines: Orthopedics
                Keywords: intervertebral disc degeneration,spinal fusion
                Data availability:
                ScienceOpen disciplines: Orthopedics
                Keywords: intervertebral disc degeneration, spinal fusion

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