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The effects of lumbar fusion and non-fusion surgery on the development of Modic changes
Xiaoping Mu1, Seong Woong Kim2, Eberhard Uhl2
1Department of Spine Surgery, The People's Hospital of Guangxi Zhuang Autonomous Region, Guangxi Academy of Medical Sciences, No. 6, Taoyuan Road, Nanning, 530021, Guangxi, China. muxbin1991@hotmail.com.
Background:
The aim of this study was to investigate the influence of lumbar fusion and non-fusion surgery on the postoperative development of Modic changes (MCs).
Methods:
A total of 270 patients who underwent lumbar fusion, microsequestrectomy, microdiscectomy, and microdecompression, and who were examined by pre- and postoperative magnetic resonance imaging during the period of January 2012 to December 2018, were included in this retrospective study. The incidence of new postoperative MCs and the change of volume of preexisting MCs after surgery were investigated.
Results:
The total incidence of new MCs following lumbar surgical procedures was 36.3%. Lumbar fusion showed a tendency towards a lower postoperative incidence of new MCs than the other three lumbar surgical procedures. The first postoperative year seems to be the most active phase for the development of new MCs. The postoperative volumes of MCs in patients who underwent lumbar non-fusion procedures were significantly greater than those before surgery (P < 0.01). However, no significant difference was detected between pre- and postoperative volumes of MCs in patients with lumbar fusion (P > 0.05).
Conclusion:
Lumbar surgical procedures contribute to the development of new MCs, particularly non-fusion surgeries. However, further studies are needed to confirm the clinical relevance of these findings.
Insights
Lumbar surgery can cause new Modic changes (MCs), especially non-fusion procedures. Lumbar fusion surgery showed a lower incidence of new MCs post-operation.
Area of Science:
- Spinal Surgery
- Radiology
- Orthopedics
Background:
- Modic changes (MCs) are common findings on MRI after lumbar spine surgery.
- The impact of different surgical techniques on MC development is not fully understood.
Purpose of the Study:
- To investigate the influence of lumbar fusion versus non-fusion surgery on postoperative Modic changes (MCs).
Main Methods:
- Retrospective study of 270 patients undergoing lumbar fusion, microsequestrectomy, microdiscectomy, or microdecompression.
- Pre- and postoperative MRI scans were analyzed to assess new MC incidence and volume changes of existing MCs.
Main Results:
- Overall incidence of new MCs was 36.3% post-lumbar surgery.
- Lumbar fusion showed a trend towards lower new MC incidence compared to non-fusion procedures.
- Non-fusion surgeries were associated with significantly increased MC volumes post-operation, while fusion surgeries showed no significant change.
Conclusions:
- Lumbar surgical procedures, particularly non-fusion types, contribute to the development of new Modic changes.
- Further research is required to establish the clinical significance of these postoperative Modic changes.
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