PMID- 33461335
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220805
IS  - 2192-5682 (Print)
IS  - 2192-5690 (Electronic)
IS  - 2192-5682 (Linking)
VI  - 12
IP  - 5
DP  - 2022 Jun
TI  - Lumbar Disc Herniation and Preoperative Modic Changes: A Prospective Analysis of 
      the Clinical Outcomes After Microdiscectomy.
PG  - 940-951
LID - 10.1177/2192568220976089 [doi]
AB  - STUDY DESIGN: Prospective comparative cohort study. OBJECTIVES: The study aims to 
      elucidate the relationship between Modic endplate changes and clinical outcomes 
      after a lumbar microdiscectomy. METHODS: Consecutive patients undergoing 
      microdiscectomy for lumbar disc herniation (LDH) were prospectively studied. 
      Pre-operative clinical and radiological parameters were recorded. The pain was 
      assessed by Numeric pain rating scale (NPRS), and functional assessment by 
      Oswestry Disability Index (ODI). Minimal clinically important difference (MCID) 
      in outcome was calculated for both the groups. Complications related to surgery 
      were studied. Follow-up was done at 6 weeks, 3 months, 6 months and 1 year. Mac 
      Nab criteria were used to assess patient satisfaction at 1 year. RESULTS: Out of 
      309 patients, 86 had Modic changes, and 223 had no Modic changes. Both groups had 
      similar back pain (p-value: 0.07) and functional scores (p-value: 0.85) 
      pre-operatively. Postoperatively patients with Modic changes had poorer back pain 
      and ODI scores in the third month, sixth month and 1 year (p-value: 0.001). 
      However, MCID between the groups were not significant (p-value: 0.18 for back 
      pain and 0.58 for ODI scores). Mac Nab criteria at 1 year were worse in Modic 
      patients (p-value: 0.001). No difference was noted among Modic types in the 
      pre-operative and postoperative pain and functional outcomes. Four patients in 
      Modic group (4.7%) and one patient in the non-Modic group (0.5%) developed 
      postoperative discitis (p-value: 0.009). CONCLUSIONS: Preoperative Modic changes 
      in lumbar disc herniation is associated with less favorable back pain, functional 
      scores and patient satisfaction in patients undergoing microdiscectomy.
FAU - Kumarasamy, Dinesh
AU  - Kumarasamy D
AD  - Department of Spine Surgery, Ganga Hospital, Coimbatore, India.
FAU - Rajasekaran, Shanmuganathan
AU  - Rajasekaran S
AUID- ORCID: 0000-0001-6043-006X
AD  - Department of Spine Surgery, Ganga Hospital, Coimbatore, India.
FAU - Anand K S, Sri Vijay
AU  - Anand K S SV
AD  - Department of Spine Surgery, Ganga Hospital, Coimbatore, India.
FAU - Soundararajan, Dilip Chand Raja
AU  - Soundararajan DCR
AD  - Department of Spine Surgery, Ganga Hospital, Coimbatore, India.
FAU - Shetty T, Ajoy Prasad
AU  - Shetty T AP
AUID- ORCID: 0000-0001-5885-7152
AD  - Department of Spine Surgery, Ganga Hospital, Coimbatore, India.
FAU - Kanna P, Rishi Mugesh
AU  - Kanna P RM
AUID- ORCID: 0000-0001-5817-4909
AD  - Department of Spine Surgery, Ganga Hospital, Coimbatore, India.
FAU - Pushpa, B T
AU  - Pushpa BT
AUID- ORCID: 0000-0001-8451-1729
AD  - Department of Radiology, Ganga Hospital, Coimbatore, India.
LA  - eng
PT  - Journal Article
DEP - 20210119
PL  - England
TA  - Global Spine J
JT  - Global spine journal
JID - 101596156
PMC - PMC9344507
OTO - NOTNLM
OT  - discitis
OT  - endplate changes
OT  - low back pain
OT  - lumbar disc herniation
OT  - microdiscectomy
OT  - modic changes
OT  - outcomes
COIS- Declaration of Conflicting Interests: The author(s) declared no potential 
      conflicts of interest with respect to the research, authorship, and/or 
      publication of this article.
EDAT- 2021/01/20 06:00
MHDA- 2021/01/20 06:01
PMCR- 2021/01/19
CRDT- 2021/01/19 05:35
PHST- 2021/01/20 06:00 [pubmed]
PHST- 2021/01/20 06:01 [medline]
PHST- 2021/01/19 05:35 [entrez]
PHST- 2021/01/19 00:00 [pmc-release]
AID - 10.1177_2192568220976089 [pii]
AID - 10.1177/2192568220976089 [doi]
PST - ppublish
SO  - Global Spine J. 2022 Jun;12(5):940-951. doi: 10.1177/2192568220976089. Epub 2021 
      Jan 19.