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European Spine Journal
Published in: European Spine Journal 11/2016

01-11-2016 | Review Article

Do Modic changes have an impact on clinical outcome in lumbar spine surgery? A systematic literature review

Authors: Aske Foldbjerg Laustsen, Rachid Bech-Azeddine

Published in: European Spine Journal | Issue 11/2016

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Abstract

Purpose

To provide a systematic literature review of the impact of preoperative Modic changes (MCs) on the clinical outcome following lumbar spine surgery for degenerative lumbar spine disease.

Methods

A PubMed search until 31 October 2015 was performed to identify publications correlating preoperative MC with clinical outcome in patients undergoing spine surgery.

Results

Inclusion criteria were met by 14 articles (7 prospective and 7 retrospective studies) representing a total of 1652 surgical patients, of which at least 804 (>49 %) showed MC. Of the 14 publications, 6 concerned discectomy (n = 607), 1 fusion versus discectomy (n = 91), 3 fusion surgery (n = 454), and 4 total disc replacement (TDR, n = 500). A trend toward less improvement in low back pain or Oswestry Disability Index score was found in the discectomy studies, and a trend toward increased improvement was demonstrated in the TDR studies when MC was present preoperatively. The fusion studies were of low evidence, and showed conflicting results.

Conclusion

Preoperative MC showed a trend toward a negative correlation with clinical improvement in patients undergoing discectomy for LDH and a positive correlation with clinical improvement in patients undergoing TDR for degenerative disc disease. However, it is questionable whether the differences surpass the minimal clinically important difference (MCID). In patients undergoing fusion surgery, there was insufficient evidence to draw any conclusions. Future studies should include a larger patient material, focus on MCID, and include known confounding factors of the clinical outcome of spine surgery in the analysis.
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Metadata
Title
Do Modic changes have an impact on clinical outcome in lumbar spine surgery? A systematic literature review
Authors
Aske Foldbjerg Laustsen
Rachid Bech-Azeddine
Publication date
01-11-2016
Publisher
Springer Berlin Heidelberg
Published in
European Spine Journal / Issue 11/2016
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-016-4609-y

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