PMID- 32157388
OWN - NLM
STAT- MEDLINE
DCOM- 20210623
LR  - 20210623
IS  - 1432-0932 (Electronic)
IS  - 0940-6719 (Linking)
VI  - 29
IP  - 9
DP  - 2020 Sep
TI  - The influence of endplate (Modic) changes on clinical outcomes in lumbar spinal 
      stenosis surgery: a Swiss prospective multicenter cohort study.
PG  - 2205-2214
LID - 10.1007/s00586-020-06364-0 [doi]
AB  - PURPOSE: To investigate if the presence or absence of preoperative endplate Modic 
      changes (MC) is predictive for clinical outcomes in degenerative lumbar spinal 
      stenosis (DLSS) patients undergoing decompression-alone or decompression with 
      instrumented fusion surgery. METHODS: Two hundred five patients were included and 
      categorized into four groups; 102 patients into the decompression-alone group 
      with MCs, 41 patients into the fusion group with MCs, 46 patients into the 
      decompression-alone group without MCs, and 16 patients into the fusion group 
      without MCs. Clinical outcome was quantified with changes in spinal stenosis 
      measure (SSM) symptoms, SSM function, NRS pain, and EQ-5D-3L sum score over time 
      (measured at baseline, 12-, 24-, and 36-month follow-up) and minimal clinically 
      important difference (MCID) in SSM symptoms, SSM function, and NRS pain from 
      baseline to 36-month follow-up. To investigate if possible effects of MCs had 
      been modified or hidden by confounding variables, we used the group LASSO method 
      to search for good prognostic models. RESULTS: There were no obvious differences 
      in any of the clinical outcome measures between groups at baseline. At 12 months, 
      most patients have improved in all outcomes and maintained improved conditions 
      over time (no significant group differences). Between 70 and 90 percent of the 
      patients maintained a clinically important improvement up to 36 months. 
      CONCLUSIONS: Endplate MCs have no significant influence on clinical outcome 
      parameters in patients with lumbar spinal stenosis compared to patients without 
      MCs, independent of the chosen surgical strategy. All patients benefitted from 
      surgical therapy up to 36-month follow-up. These slides can be retrieved under 
      Electronic Supplementary Material.
FAU - Ulrich, Nils H
AU  - Ulrich NH
AD  - Horten Centre for Patient Oriented Research and Knowledge Transfer, University of 
      Zurich, Zurich, Switzerland. nils.hb.ulrich@gmail.com.
AD  - University Spine Centre Zurich, Balgrist University Hospital, University of 
      Zurich, Zurich, Switzerland. nils.hb.ulrich@gmail.com.
FAU - Burgstaller, Jakob M
AU  - Burgstaller JM
AD  - Horten Centre for Patient Oriented Research and Knowledge Transfer, University of 
      Zurich, Zurich, Switzerland.
FAU - Gravestock, Isaac
AU  - Gravestock I
AD  - Horten Centre for Patient Oriented Research and Knowledge Transfer, University of 
      Zurich, Zurich, Switzerland.
FAU - Winklhofer, Sebastian
AU  - Winklhofer S
AD  - Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, 
      University of Zurich, Zurich, Switzerland.
FAU - Porchet, Francois
AU  - Porchet F
AD  - Department of Orthopedics and Neurosurgery, Spine Center, Schulthess Clinic, 
      Zurich, Switzerland.
FAU - Pichierri, Giuseppe
AU  - Pichierri G
AD  - Horten Centre for Patient Oriented Research and Knowledge Transfer, University of 
      Zurich, Zurich, Switzerland.
FAU - Wertli, Maria M
AU  - Wertli MM
AD  - Horten Centre for Patient Oriented Research and Knowledge Transfer, University of 
      Zurich, Zurich, Switzerland.
AD  - Division of General Internal Medicine, Bern University Hospital, Bern University, 
      Bern, Switzerland.
FAU - Steurer, Johann
AU  - Steurer J
AD  - Horten Centre for Patient Oriented Research and Knowledge Transfer, University of 
      Zurich, Zurich, Switzerland.
FAU - Farshad, Mazda
AU  - Farshad M
AD  - University Spine Centre Zurich, Balgrist University Hospital, University of 
      Zurich, Zurich, Switzerland.
CN  - LSOS Study Group
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20200310
PL  - Germany
TA  - Eur Spine J
JT  - European spine journal : official publication of the European Spine Society, the 
      European Spinal Deformity Society, and the European Section of the Cervical Spine 
      Research Society
JID - 9301980
SB  - IM
MH  - Decompression, Surgical
MH  - Humans
MH  - Lumbar Vertebrae/surgery
MH  - Prospective Studies
MH  - *Spinal Fusion
MH  - *Spinal Stenosis/surgery
MH  - Switzerland
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Decompression
OT  - Degenerative lumbar spinal stenosis
OT  - Endplate
OT  - Fusion
OT  - Modic changes
EDAT- 2020/03/12 06:00
MHDA- 2021/06/24 06:00
CRDT- 2020/03/12 06:00
PHST- 2019/10/23 00:00 [received]
PHST- 2020/03/03 00:00 [accepted]
PHST- 2020/01/26 00:00 [revised]
PHST- 2020/03/12 06:00 [pubmed]
PHST- 2021/06/24 06:00 [medline]
PHST- 2020/03/12 06:00 [entrez]
AID - 10.1007/s00586-020-06364-0 [pii]
AID - 10.1007/s00586-020-06364-0 [doi]
PST - ppublish
SO  - Eur Spine J. 2020 Sep;29(9):2205-2214. doi: 10.1007/s00586-020-06364-0. Epub 2020 
      Mar 10.