Document Detail

Clinical results of lumbar total disc arthroplasty in accordance with Modic signs, with a 2-year-minimum follow-up.
MedLine Citation:
PMID:  21252824     Owner:  NLM     Status:  MEDLINE    
STUDY DESIGN: Prospective study.
OBJECTIVE: The aim of this prospective study is to analyze the influence of Modic type on the clinical results of lumbar total disc arthroplasty.
SUMMARY OF BACKGROUND DATA: Some patients with lumbar disc degeneration have endplate signal changes on magnetic resonance images, which have been classified by Modic. Modic-1 endplates changes are associated with an inflammatory phase of the disease whereas Modic-2 endplates changes correspond to a quiescent phase with a fatty replacement. The effect of Modic endplate changes on the clinical results of lumbar fusion has been studied by multiple authors, but the influence of Modic type on clinical outcomes of lumbar disc replacement is not known.
METHODS: A total of 221 patients with a mean age of 42 years were included in this study. Of which, 107 patients were classified Modic 0, 65 Modic 1, and 49 Modic 2. Clinical evaluation (Oswestry Disability Index [ODI], lumbar and radicular pain using the Visual Analog Score [VAS]) was performed preoperatively and at 3, 6, 12, and 24 months minimum postoperatively.
RESULTS: Mean follow-up was 30 months (24-72 months). Significant clinical improvement (P < 0.05) was observed in pain and ODI between the preoperative evaluation and final follow-up. Multivariate analysis between the 3 groups demonstrated a significant difference in Oswestry Disability Index (size of the effect was measured at -0.3 [-0.55-0.04]) and on the radicular pain (size of the effect was measured at -0.4 [-0.7-0.1]), with lower scores in the group classified Modic 1.
CONCLUSION: Superior results were achieved in the group of patients with Modic-1 endplate changes on magnetic resonance images. These data may be helpful in patient selection and in preoperative patient counseling.
Benjamin Blondel; Patrick Tropiano; Jean Gaudart; Russel C Huang; Thierry Marnay
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Spine     Volume:  36     ISSN:  1528-1159     ISO Abbreviation:  Spine     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2011-12-14     Completed Date:  2012-05-11     Revised Date:  2012-06-22    
Medline Journal Info:
Nlm Unique ID:  7610646     Medline TA:  Spine (Phila Pa 1976)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2309-15     Citation Subset:  IM    
Orthopedic and Vertebral Department, Hôpital Nord, Université de la Méditerranée, Marseille, France.
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MeSH Terms
Disability Evaluation
Follow-Up Studies
Intervertebral Disc / radiography,  surgery*
Intervertebral Disc Degeneration / classification,  diagnosis,  surgery*
Lumbar Vertebrae / radiography,  surgery*
Magnetic Resonance Imaging / methods
Middle Aged
Multivariate Analysis
Pain Measurement / methods
Prospective Studies
Time Factors
Total Disc Replacement / methods*
Treatment Outcome
Young Adult
Comment In:
Spine (Phila Pa 1976). 2012 May 15;37(11):1014-5; author reply 1016   [PMID:  22576043 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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