The clinical outcomes comparison between interbody infusion and simple discectomy for single segmental lumbar disc herniation with type Ⅱ Modic changes

English Keywords:Lumbar disc herniation  Modic Ⅱ change  Interbody fusion  Simple discectomy  Surgical outcome

English Abstract:

  【Abstract】 Objectives: To compare the clinical results of simple discectomy and interbody infusion in single segmental lumbar disc herniation(LDH) with type Ⅱ Modic changes(MCs). Methods: Sixty-two patients suffering from LDH with type Ⅱ MCs treated in our hospital from January 2008 to January 2012 were included in the study. Patients were randomly divided into interbody fusion group and simple discectomy group. There were 31 patients(14 males and 17 females, 17 L4/5 and 14 L5/S1) in the interbody fusion group with a mean age of 40.77±10.27 years(range, 26-58 years). In the simple discectomy group, there were 31 patients(16 males and 15 females, 15 L4/5 and 16 L5/S1) with a mean age of 38.48±9.77 years(range, 25-56 years). There were no significant differences between group A and B in the number of cases, gender, average age, average duration and involved segments(P>0.05). Visual analog scale(VAS) pain scores and Oswestry disability index(ODI) scores were recorded at 1 day preoperatively, 6 and 12 months postoperatively. Macnab clinical efficacy was evaluated at 6 and 12 months postoperatively. Results: Fifty-four patients completed the follow-ups(28 cases in group A and 26 cases in group B). Preoperative VAS and ODI scores showed no statistical differences between 2 groups(P>0.05). The postoperative VAS and ODI scores at 6 and 12 months were significantly lower than the preoperative ones(P<0.05). However, there were no statistical differences between the postoperative 6 and 12 month scores(P>0.05). Low back pain VAS score and ODI score in the interbody fusion group were statistical lower than those in simple discectomy group at 6 and 12 months postoperatively(P<0.05), but the leg pain VAS score showed no statistical difference(P>0.05). According to Macnab result, at 6 months after operation, surgical outcomes were as follows: 20 excellent, 6 good and 2 fair in group A; 10 excellent, 12 good and 4 fair in group B. At 12 months after operation, surgical outcomes were as follows: 22 excellent, 5 good and 1 fair in group A; 13 excellent, 10 good and 3 fair in group B, the interbody fusion group had better results than the simple discectomy group(P<0.05). Conclusions: The early results of interbody fusion are better than those of simple discectomy for single segmental LDH with type Ⅱ MCs.