Low Back Pain After Lumbar Discectomy in Patients Showing Endplate Modic Type 1 Change

Ohtori, Seiji; Yamashita, Masaomi; Yamauchi, Kazuyo; Inoue, Gen; Koshi, Takana; Suzuki, Mitsuaki; Orita, Sumihisa; Eguchi, Yawara; Ochiai, Nobuyasu; Kishida, Shunji; Takaso, Masashi; Aoki, Yasuchika; Ishikawa, Tetsuhiro; Arai, Gen; Miyagi, Masayuki; Kamoda, Hiroto; Nakamura, Junichi; Takahashi, Kazuhisa

doi:10.1097/brs.0b013e3181cd2cb8

Cited by 64 publications

(68 citation statements)

References 13 publications

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“…In ten studies the patients underwent microdiscectomy [11,36–38,41–43,45,47,50]. Six studies documented that the patients were treated with standard open discectomy [32,34,40,44,48,49]. Two studies [16,51] included patients who were operated both with and without a microscope.…”

Section: Resultsmentioning

confidence: 99%

Risk Factors for Postoperative Pain Intensity in Patients Undergoing Lumbar Disc Surgery: A Systematic Review

et al. 2017

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ObjectivesPain relief has been shown to be the most frequently reported goal by patients undergoing lumbar disc surgery. There is a lack of systematic research investigating the course of postsurgical pain intensity and factors associated with postsurgical pain. This systematic review focuses on pain, the most prevalent symptom of a herniated disc as the primary outcome parameter. The aims of this review were (1) to examine how pain intensity changes over time in patients undergoing surgery for a lumbar herniated disc and (2) to identify socio-demographic, medical, occupational and psychological factors associated with pain intensity.MethodsSelection criteria were developed and search terms defined. The initial literature search was conducted in April 2015 and involved the following databases: Web of Science, Pubmed, PsycInfo and Pubpsych. The course of pain intensity and associated factors were analysed over the short-term (≤ 3 months after surgery), medium-term (> 3 months and < 12 months after surgery) and long-term (≥ 12 months after surgery).ResultsFrom 371 abstracts, 85 full-text articles were reviewed, of which 21 studies were included. Visual analogue scales indicated that surgery helped the majority of patients experience significantly less pain. Recovery from disc surgery mainly occurred within the short-term period and later changes of pain intensity were minor. Postsurgical back and leg pain was predominantly associated with depression and disability. Preliminary positive evidence was found for somatization and mental well-being.ConclusionsPatients scheduled for lumbar disc surgery should be selected carefully and need to be treated in a multimodal setting including psychological support.

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Section: Resultsmentioning

confidence: 99%

Risk Factors for Postoperative Pain Intensity in Patients Undergoing Lumbar Disc Surgery: A Systematic Review

et al. 2017

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“…Two recent studies have evaluated the influence of Modic changes on improvement of LBP after lumbar microdiscectomy; Chin et al [11] found a trend toward greater improvement in patients without any MC. Ohtori et al [12] recently compared outcomes after microdiscectomy amongst patients with or without MC I, but found no statistically significant difference. These studies were probably underpowered and smoking habits were not evaluated.…”

Section: Discussionmentioning

confidence: 99%

“…Some patients with CLBP and MC I changes are operated with total disc replacement [10,11]. It has also been suggested that MC I is associated with hypermobility which could indicate the need for additional fusion surgery amongst these patients [12]. Previous studies with small smaples evaluating a possible association between MC and reduced recovery of back pain after lumbar microdiscectomy present conflicting results [11,12].…”

Section: Introductionmentioning

confidence: 99%

Modic type I changes and recovery of back pain after lumbar microdiscectomy

et al. 2012

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Purpose To investigate whether the presence of Modic changes type I (MC I) found on preoperative MRI scans represent a risk factor for persistent back pain 12 months after surgery amongst patients operated for lumbar disc herniation. Methods Cohort study of 178 consecutive patients operated with lumbar microdiscectomy. Preoperative MRI scans were evaluated by two independent neuroradiologists. Primary outcome measure was the visual analogue scale (VAS) for back pain. Secondary outcome measures were; VAS for leg pain, physical function (Oswestry Disability Index), and health-related quality of life (EQ-5D), self-reported benefit of the operation and employment status. The presence of MC I was used as exposition variable and adjusted for other risk factors in multivariate analyses. Results The Modic classification showed a high interobserver reproducibility. Patients with MC I had less improvement of back pain 12 months after surgery, compared to those who had no or other types of MC, but this negative association no longer showed statistical significance when adjusted for smoking, which remained the only independent risk factor for persistent back pain. Conclusions Patients with preoperative MC I can expect less but still significant improvement of back pain 1 year after microdiscectomy, but not if they smoke cigarettes.

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“…New type I and new type II conversions have been associated to the occurrence of low back pain and unfavourable outcomes in patients affected by lumbar disc herniation [8] and after lumbar discectomy [12], respectively. However, such correlation is still controversial among studies [12,14,15].…”

Section: Discussionmentioning

confidence: 99%

The course of Modic vertebral body changes after posterolateral lumbar fusion on fused and adjacent levels: A systematic review of the literature

Portella

Acioly

2017

Journal of Clinical Neuroscience

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Low Back Pain After Lumbar Discectomy in Patients Showing Endplate Modic Type 1 Change

Cited by 64 publications

References 13 publications

Risk Factors for Postoperative Pain Intensity in Patients Undergoing Lumbar Disc Surgery: A Systematic Review

Risk Factors for Postoperative Pain Intensity in Patients Undergoing Lumbar Disc Surgery: A Systematic Review

Modic type I changes and recovery of back pain after lumbar microdiscectomy

The course of Modic vertebral body changes after posterolateral lumbar fusion on fused and adjacent levels: A systematic review of the literature

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