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Late appearance of low back pain relating to Modic change after lumbar discectomy
Keyvan Mostofi1, Babak Gharaei Moghaddam2, Morad Peyravi3
1Department of Neurosurgery, Centre Clinical, Chirurgie De Rachis, Soyaux, France.
Background:
In practice of neurosurgery, we find that a wide number of patients referred for refractory low back pain have a history of lumbar discectomy. In a large number of them, magnetic resonance imaging (MRI) studies detect Modic changes (MCs). The aim of this study is to determine the relationship between emergence of MC and low back after lumbar discectomy.
Materials And Methods:
Three hundred and fifty-eight patients with a medical history of discectomy had a MC at the level of the operated disc without any other discopathy. They have been selected from among the 1154 patients operated for lumbar disc herniation over 5 years.
Results:
Two hundred and fourteen patients (67.30%) had not presented MCs on preoperative MRI.
Conclusion:
Our study awakens a strong presumption about the relationship between emergence of MC after lumbar discectomy.
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Consider a gas confined to a cylinder fitted with a movable piston at one end. If the gas expands from volume V1 to volume V2, it exerts a force on the piston, such that the piston moves by a distance dr.
The work done by the gas on the piston can be expressed as

