The Clinical Significance of the Modic Changes Grading Score.

Autor:	Udby PM; Spine Unit, Department of Orthopedic Surgery, Zealand University Hospital, Koege, Denmark.; Spine Surgery and Research, Spine Center of Southern Denmark, Lillebaelt Hospital, Middelfart, Denmark., Modic M; Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA., Elmose S; Spine Surgery and Research, Spine Center of Southern Denmark, Lillebaelt Hospital, Middelfart, Denmark., Carreon LY; Spine Surgery and Research, Spine Center of Southern Denmark, Lillebaelt Hospital, Middelfart, Denmark., Andersen MØ; Spine Surgery and Research, Spine Center of Southern Denmark, Lillebaelt Hospital, Middelfart, Denmark., Karppinen J; Medical Research Center Oulu, Oulu University Hospital, University of Oulu, Oulu, Finland.; Rehabilitation Services of South Karelia Social and Health Care District, Lappeenranta, Finland., Samartzis D; Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA.; International Spine Research and Innovation Initiative, Rush University Medical Center, Chicago, IL, USA.
Jazyk:	angličtina
Zdroj:	Global spine journal [Global Spine J] 2024 Apr; Vol. 14 (3), pp. 796-803. Date of Electronic Publication: 2022 Aug 23.
DOI:	10.1177/21925682221123012
Abstrakt:	Study Design: Cross-sectional retrospective observational study. Objective: To evaluate the reliability and clinical utility of the Modic changes (MC) grading score. Method: Patients from the Danish national spine registry, DaneSpine, scheduled for lumbar discectomy were identified. MRI of patients with MC were graded based on vertical height involvement: Grade A (<25%), Grade B (25%-50%), and Grade C (>50%). All MRIs were reviewed by 2 physicians to evaluate the reliability of the MC grade. Results: Of 213 patients included, 142 patients had MC, 71 with MC-1 and 71 with MC-2; 34% were Grade A, 45% were Grade B, and 21% were Grade C. MC grade demonstrated substantial intra-rater (κ = .68) and inter-rater (κ = .61) reliability. A significantly higher proportion (n = 40, 57%) of patients with MC-1 had a severe MC grade compared to patients with MC-2 (n = 30, 43%, P < .001). Severe MC grade was associated with the presence of severe lumbar disc degeneration (DD) (Pfirrmann grade = V, P = .024), worse preoperative ODI (52.49 vs 44.17, P = .021) and EQ-5D scores (.26 vs .46, P = .053). MC alone including type was not associated with a significant difference in patient-reported outcomes ( P > .05). Conclusion: The MC grade score was demonstrated to have substantial intra- and inter-observer reliability. Severe MC grade was associated with both severe DD and MC type, being more prevalent in patients with MC-1. The MC grade was also significantly associated with worse disability and reduced health-related quality of life. Results from the study suggest that MC grade is more clinically important than MC type. Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Databáze:	MEDLINE
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