The outcome of microendoscopic discectomy for disc herniation complicated with lumbar endplate Modic changes

English Keywords:Lumbar disc herniation  Microendoscopic discectomy  lower back pain  Modic changes  lumbar endplate

English Abstract:

  【Abstract】 Objective：To evaluate the outcome of microendoscopic discectomy for disc herniation complicated with lumbar endplate Modic changes.Method：78 patients including 43 mals and 35　femals，aged from 23 to 67　years old （mean 44.3 years）　suffering from single level disc herniation in L4-L5 or L5-S1 from May 2005 to December 2009 were reviewed retrospectively，of them，３３ had ｎｏ　lumbar endplate Modic changes （group A），４５ had ｌｕｍｂａｒ　ｅｎｄｐｌａｔｅ　Ｍｏｄｉｃ　ｃｈａｎｇｅｓ　（group B），cases with Modｉc Ⅰ，Ⅱ，Ⅲ-type accounted 13，25，7，respectively.All patients underwent microendoscopic discectomy and at least 7 month follow-up （mean 36.7 months），the VAS and ODI scales at the preoperative and final follow－up were compared between two groups.Result：Ｔｈｅｒｅ　ｗａｓ　ｎｏ　ｄｉｆｆｅｒｅｎｃｅ　ｂｅｔｗｅｅｎ　two groups ｂｅfｏｒｅ operation with respect to VAS （low back pain）　and ODI　（P>0.05），ｈｏｗｅｖｅｒ，ｓｉｇｎｉｆｉｃａｎｔ　ｄｉｆｆｅｒｅｎｃｅ between two groups was noted after operation （P<0.05）．ODI scales increased 86.2% and 81.3% for group　A and B respectively；VAS scales increased 89.2% in group Ａ and 77.2% in group Ｂ，which showed statistical significance （P<0.05），however，no statistical significance respect to either VAS （lower back pain） or ODI among three types of Modic change in group Ｂ was noted ａｔ　ｔｈｅ　ｐｒｅｏｐｅｒａｔｉｖｅ　ａｎｄ　ｆｉｎａｌ　ｆｏｌｌｏw－ｕｐ （P>0.05）.Conclusion：MED is effective for lumbar disc herniation，Modic changes in endplate may lead to postoperative low back pain，and even poor prognosis，moreover the outcomeｓ of MED for different typeｓ of Modic changeｓ remain no difference.