Journal of Neurosurgical Sciences 2021 Aug 03

DOI: 10.23736/S0390-5616.21.05386-8

Copyright © 2021 EDIZIONI MINERVA MEDICA

lingua: Inglese

The effect of modic changes on the fusion rates of posterior interbody fusion surgery modic changes and posterior interbody fusion

Samet ERINÇ ¹ ✉, Mahmet A. TALMAÇ ¹, Bahattin KEMAH ², Mustafa H. ÖZDEMİR ¹

¹ Department of Orthopedics and Traumatology Service, ŞişliHamidiyeEtfal Research and Training Hospital, İstanbul, Turkey; ² Department of Orthopedics and Traumatology Service, Ümraniye Research and Training Hospital, İstanbul, Turkey

BACKGROUND: Modic changes have been correlated to low back pain, spinal instability. The objective of this study was to evaluate the effect of Modic changes on the fusion rates of instrumented posterior interbody fusion surgery (PLIF).
METHODS: The study included patients who underwent PLIF surgery between 2015 - 2019.The patients were separated into 4 groups according to Modic changes detected in the preoperative MRI. Fusion, subsidence were evaluated with postoperative CT and xray. Body mass index (BMI) and bone mineral density (BMD) of the patients were also evaluated.
RESULTS: The study included 137 operated discs of 86 patients. There was no statistically difference between groups regarding age, gender, follow - up period, BMI, and BMD. There were 70 levels with no Modic changes (M0), 26 levels with Modic type 1 (M1), 21 levels with Modic type 2 (M2), and 16 with Modic type 3 (MC3) change. The rate of successful fusion was 92.9 % in M0, 92.3 % in M1, 93 % in M2, and 93.7 % in M3. The rate of high-grade subsidence was 28.5 % in M0, 26.8 % in M1, 27.5 % in M2, and 24.9 % in M3. There was no statistically difference between the patients regarding subsidence grade or fusion rate.
CONCLUSIONS: Modic changes were not observed to be directly correlated to the radiological outcomes of instrumented posterior interbody fusion. The fusion rate demonstrated homogenous distribution between the Modic groups and the subsidence rate was slightly higher in MC1 and MC2 than in MC3 and MC0.

KEY WORDS: Modic changes; PLIF; Interbody fusion; Disc degeneration