Does Preoperative Modic Changes Influence the Short-term Fusion Rate of Single Level Transforaminal Lumbar Interbody...

Area of Science:

• Spine surgery
• Orthopedics
• Radiology

Background:

• Modic changes (MCs) are common findings in degenerative lumbar spine disease.
• The impact of MCs on short-term lumbar interbody fusion (LIF) success remains under-investigated.
• Understanding MCs' influence is crucial for predicting early postoperative outcomes.

Purpose of the Study:

• To compare the short-term bony fusion and cage union rates in patients with and without Modic changes (MCs) after single-level transforaminal lumbar interbody fusion (TLIF).
• To evaluate the effect of MCs on early postoperative fusion success following TLIF.

Main Methods:

• A retrospective, matched-pair case-control study involving 100 patients undergoing TLIF.
• Patients were divided into MCs group (n=50) and non-MCs group (n=50), matched for key demographic and surgical variables.
• Radiographic assessment (X-ray, CT) evaluated bony fusion and cage union from 3 months to 2 years postoperatively.

Main Results:

• Significantly lower bony fusion rates were observed in the MCs group at 3 months, 6 months, 1 year, and 2 years post-surgery compared to the non-MCs group.
• The MCs group demonstrated significantly lower average coronal and sagittal cage union ratios.
• Fusion rates between nano-hydroxyapatite/polyamide 66 (n-HA/PA66) and polyetheretherketone (PEEK) cages were comparable within the MCs group.

Conclusions:

• Modic changes are associated with reduced short-term bony fusion rates after TLIF.
• The presence of MCs negatively impacts early cage union in both coronal and sagittal planes.
• Cage type (n-HA/PA66 vs. PEEK) did not significantly alter fusion performance in patients with MCs.