Course of Modic 1 six months after lumbar posterior osteosynthesis
| Autor: | C. Schaelderle, S. Azzouz, Jean Marc Vital, F. Razanabola, Vincent Pointillart, Olivier Gille, P. Bacon, M. Pedram |
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| Rok vydání: | 2003 |
| Předmět: |
Adult
Male medicine.medical_specialty Arthrodesis medicine.medical_treatment Spondylolysis Lumbar Osteogenesis Predictive Value of Tests Discectomy medicine Humans Orthopedics and Sports Medicine Prospective Studies Pain Measurement Osteosynthesis Lumbar Vertebrae business.industry Lumbosacral Region Modic changes Middle Aged medicine.disease Low back pain Magnetic Resonance Imaging Spondylolisthesis Surgery Radiography Spinal Fusion Treatment Outcome Chronic Disease Quality of Life Female Neurology (clinical) medicine.symptom business Low Back Pain Intervertebral Disc Displacement Diskectomy Follow-Up Studies |
| Zdroj: | Spine. 28(7) |
| ISSN: | 1528-1159 |
| Popis: | Study design A prospective study was conducted to investigate the outcome of the Modic Type 1 inflammatory signal in magnetic resonance imaging (MRI) in 17 patients with chronic low back pain 6 months after instrumented posterior lumbar arthrodesis. Objective To assess the course of the inflammatory signal after stabilization of a painful intervertebral segment by posterior instrumentation alone visualized on MRI systematically performed 6 months after the operation. Summary of background data In 1988, Modic and colleagues described three degenerative stages of vertebral endplates and subchondral bone. The inflammatory stage, or Stage 1, is correlated with substantial functional disability. According to these authors, Stage 1 lesions naturally transform into Stage 2, the fatty stage. In the literature, patients with Modic 1 signal tend to have good results after arthrodesis, better than those with Modic 2 lesions. Methods This study included 17 patients (average age, 46 years) who had experienced chronic low back pain more than 1 year and showed Modic 1 changes in MRI and disc narrowing on plain radiographs. Every patient underwent posterior screw-rod osteosynthesis and posterolateral arthrodesis. Disc disease had occurred subsequently to discectomy (n = 7), rapidly destructive disc disease (n = 5), or spondylolisthesis resulting from spondylolysis (n = 5). Clinical results were assessed according to a visual analog scale for pain, a functional disability score for the evaluation of patients with low back pain (Eiffel), and the validated French version of the self-administered Dallas quality-of-life test (DRAD). Results Systematic MRI at 6 months showed transformation from Modic 1 to Modic 0 (normal endplate signal) in 4 patients and transformation from Modic 1 to Modic 2 in the remaining 13 patients. Clinical evaluation was performed at 6 months (at the same time as the MRI) and at 1 year. In every patient, there was improvement in the visual analog score and the functional score, which remained stable at 1 year. Conclusions According to the literature, most Modic 1 lesions change to become Stage 2 lesions in 18 to 24 months. In this study, 17 patients with Modic Type 1 signal had changes after 6 months. It appears that posterior osteosynthesis combined with posterolateral arthrodesis accelerates the course of Modic 1 lesions, probably by correcting mechanical instability. |
| Databáze: | OpenAIRE |
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