Document Detail

What happens to Modic changes following lumbar discectomy? Analysis of a cohort of 41 patients with a 3- to 5-year follow-up period.
MedLine Citation:
PMID:  21039144     Owner:  NLM     Status:  MEDLINE    
OBJECT: The natural history of Modic changes (MCs) in the lumbar spine is often marked by conversion from one type to another, but their course following lumbar discectomy remains unknown. The authors sought to study the impact of surgery on the natural history of these lesions.
METHODS: Forty-one patients treated with lumbar microdiscectomy between 2004 and 2005 were enrolled in this study and underwent clinical evaluation and repeat MR imaging after a median follow-up of 41 months (range 32-59 months). Preoperative and follow-up MR images were reviewed and the type, location, and extent of MCs at the operated level were recorded and compared.
RESULTS: The study population consisted of 27 men and 14 women with a mean age of 54 years (range 24-78 years). During the follow-up period, the prevalence of MCs increased from 46.3% to 78%, and 26 patients (63.4%) had Type 2 lesions at the operated level. Of the 22 patients without MCs, 4 (18.2%) converted to Type 1 and 9 (40.9%) to Type 2. Of the 5 Type 1 lesions, 3 (60%) converted to Type 2, and 2 (40%) remained Type 1 but increased in size. In contrast, none of the 14 Type 2 changes converted to another type, although 10 (71.4%) increased in extent. There were no reverse conversions to Type 0.
CONCLUSIONS: Following lumbar discectomy, most patients develop Type 2 changes at the operated level, possibly as a result of accelerated degeneration in the operated disc. Neither the preoperative presence of MCs nor their postoperative course appears to affect the clinical outcome.
Ralph Rahme; Ronald Moussa; Rabih Bou-Nassif; Joseph Maarrawi; Tony Rizk; Georges Nohra; Elie Samaha; Nabil Okais
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of neurosurgery. Spine     Volume:  13     ISSN:  1547-5646     ISO Abbreviation:  J Neurosurg Spine     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-11-02     Completed Date:  2010-11-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101223545     Medline TA:  J Neurosurg Spine     Country:  United States    
Other Details:
Languages:  eng     Pagination:  562-7     Citation Subset:  IM    
Department of Neurosurgery, Hôtel-Dieu de France, Saint-Joseph University, Beirut, Lebanon.
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MeSH Terms
Cohort Studies
Diskectomy / adverse effects,  methods*
Follow-Up Studies
Intervertebral Disk Displacement / diagnosis,  surgery*
Joint Instability / diagnosis,  etiology
Lumbar Vertebrae / pathology*,  surgery*
Middle Aged
Postoperative Complications
Postoperative Period
Preoperative Period
Retrospective Studies
Treatment Outcome
Young Adult
Comment In:
J Neurosurg Spine. 2010 Nov;13(5):559-60; discussion 60-1   [PMID:  21039143 ]

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