Dynamic Stabilisation in the Treatment of Degenerative Disc Disease with Modic Changes

Overview

Journal Adv Orthop

Publisher Wiley

Specialty Orthopedics

Date 2013 Jun 20

PMID 23781343

Citations 6

Authors

Olcay Eser

Cengiz Gomleksiz

Mehdi Sasani

Tunc Oktenoglu

Ahmet Levent Aydin

Yaprak Ataker

Tuncer Suzer

Ali Fahir Ozer

Affiliations

Soon will be listed here.

Abstract

Objective. Posterior dynamic stabilization is an effective alternative to fusion in the treatment of chronic instability and degenerative disc disease (DDD) of the lumbar spine. This study was undertaken to investigate the efficacy of dynamic stabilization in chronic degenerative disc disease with Modic types 1 and 2. Modic types 1 and 2 degeneration can be painful. Classic approach in such cases is spine fusion. We operated 88 DDD patients with Modic types 1 and 2 via posterior dynamic stabilization. Good results were obtained after 2 years of followup. Methods. A total of 88 DDD patients with Modic types 1 and 2 were selected for this study. The patients were included in the study between 2004 and 2010. All of them were examined with lumbar anteroposterior (AP) and lateral X-rays. Lordosis of the lumbar spine, segmental lordosis, and ratio of the height of the intervertebral disc spaces (IVSs) were measured preoperatively and at 3, 12, and 24 months after surgery. Magnetic resonance imaging (MRI) analysis was carried out, and according to the data obtained, the grade of disc degeneration was classified. The quality of life and pain scores were evaluated by visual analog scale (VAS) score and Oswestry Disability Index (ODI) preoperatively and at 3, 12, and 24 months after surgery. Appropriate statistical method was chosen. Results. The mean 3- and 12-month postoperative IVS ratio was significantly greater than that of the preoperative group (P < 0.001). However, the mean 1 and 2 postoperative IVS ratio was not significantly different (P > 0.05). Furthermore, the mean preoperative and 1 and 2 postoperative angles of lumbar lordosis and segmental lordosis were not significantly different (P > 0.05). The mean VAS score and ODI, 3, 12, and 24 months after surgery, decreased significantly, when compared with the preoperative scores in the groups (P = 0.000). Conclusion. Dynamic stabilization in chronic degenerative disc disease with Modic types 1 and 2 was effective.

Citing Articles

Clinical and radiological analysis of the effects of three different lumbar transpedicular dynamic stabilization system on disc degeneration and regeneration.

Karadag M, Akgun M, Basak A, Ates O, Tepebasili M, Gunerbuyuk C Front Surg. 2024; 10:1297790.

PMID: 38162089 PMC: 10757836. DOI: 10.3389/fsurg.2023.1297790.

The relationship between traction spurs, Modic change, vacuum phenomenon, and segmental instability of the lumbar spine.

Tsukamoto M, Morimoto T, Kobayashi T, Muranaka K, Yoshihara T, Maeda K Sci Rep. 2022; 12(1):9939.

PMID: 35705718 PMC: 9200777. DOI: 10.1038/s41598-022-14244-4.

Effect of Preoperative Modic Change in the Outcome of Patients with Low Back Pain Following Posterior Spinal Fusion or Laminectomy.

Shahmohammadi M, Behrouzian S Asian J Neurosurg. 2019; 14(2):432-435.

PMID: 31143258 PMC: 6516000. DOI: 10.4103/ajns.AJNS_41_18.

Transforaminal Epiduroscopic Basivertebral Nerve Laser Ablation for Chronic Low Back Pain Associated with Modic Changes: A Preliminary Open-Label Study.

Kim H, Adsul N, Yudoyono F, Paudel B, Kim K, Choi S Pain Res Manag. 2018; 2018:6857983.

PMID: 30186540 PMC: 6112211. DOI: 10.1155/2018/6857983.

Do Modic changes have an impact on clinical outcome in lumbar spine surgery? A systematic literature review.

Laustsen A, Bech-Azeddine R Eur Spine J. 2016; 25(11):3735-3745.

PMID: 27177469 DOI: 10.1007/s00586-016-4609-y.

References

Sapkas G, Themistocleous G, Mavrogenis A, Benetos I, Metaxas N, Papagelopoulos P . Stabilization of the lumbar spine using the dynamic neutralization system. Orthopedics. 2007; 30(10):859-65. DOI: 10.3928/01477447-20071001-18. View

Vital J, Gille O, Pointillart V, Pedram M, Bacon P, Razanabola F . Course of Modic 1 six months after lumbar posterior osteosynthesis. Spine (Phila Pa 1976). 2003; 28(7):715-20; discussion 721. DOI: 10.1097/01.BRS.0000051924.39568.31. View

Kjaer P, Korsholm L, Bendix T, Sorensen J, Leboeuf-Yde C . Modic changes and their associations with clinical findings. Eur Spine J. 2006; 15(9):1312-9. PMC: 2438570. DOI: 10.1007/s00586-006-0185-x. View

Buttermann G, Heithoff K, Ogilvie J, Transfeldt E, Cohen M . Vertebral body MRI related to lumbar fusion results. Eur Spine J. 1997; 6(2):115-20. PMC: 3454594. DOI: 10.1007/BF01358743. View

Ozer A, Crawford N, Sasani M, Oktenoglu T, Bozkus H, Kaner T . Dynamic lumbar pedicle screw-rod stabilization: two-year follow-up and comparison with fusion. Open Orthop J. 2010; 4:137-41. PMC: 2864427. DOI: 10.2174/1874325001004010137. View

Kuisma M, Karppinen J, Niinimaki J, Ojala R, Haapea M, Heliovaara M . Modic changes in endplates of lumbar vertebral bodies: prevalence and association with low back and sciatic pain among middle-aged male workers. Spine (Phila Pa 1976). 2007; 32(10):1116-22. DOI: 10.1097/01.brs.0000261561.12944.ff. View

Fritzell P, Hagg O, Wessberg P, Nordwall A . 2001 Volvo Award Winner in Clinical Studies: Lumbar fusion versus nonsurgical treatment for chronic low back pain: a multicenter randomized controlled trial from the Swedish Lumbar Spine Study Group. Spine (Phila Pa 1976). 2001; 26(23):2521-32; discussion 2532-4. DOI: 10.1097/00007632-200112010-00002. View

Oktenoglu T, Ozer A, Sasani M, Kaner T, Canbulat N, Ercelen O . Posterior dynamic stabilization in the treatment of lumbar degenerative disc disease: 2-year follow-up. Minim Invasive Neurosurg. 2010; 53(3):112-6. DOI: 10.1055/s-0030-1262810. View

Banwart J, Asher M, Hassanein R . Iliac crest bone graft harvest donor site morbidity. A statistical evaluation. Spine (Phila Pa 1976). 1995; 20(9):1055-60. DOI: 10.1097/00007632-199505000-00012. View

10.

Brown M, Hukkanen M, McCarthy I, Redfern D, BATTEN J, CROCK H . Sensory and sympathetic innervation of the vertebral endplate in patients with degenerative disc disease. J Bone Joint Surg Br. 1997; 79(1):147-53. DOI: 10.1302/0301-620x.79b1.6814. View

11.

Bozkus H, Senoglu M, Baek S, Sawa A, Ozer A, Sonntag V . Dynamic lumbar pedicle screw-rod stabilization: in vitro biomechanical comparison with standard rigid pedicle screw-rod stabilization. J Neurosurg Spine. 2010; 12(2):183-9. DOI: 10.3171/2009.9.SPINE0951. View

12.

Ohtori S, Inoue G, Ito T, Koshi T, Ozawa T, Doya H . Tumor necrosis factor-immunoreactive cells and PGP 9.5-immunoreactive nerve fibers in vertebral endplates of patients with discogenic low back Pain and Modic Type 1 or Type 2 changes on MRI. Spine (Phila Pa 1976). 2006; 31(9):1026-31. DOI: 10.1097/01.brs.0000215027.87102.7c. View

13.

Fayad F, Lefevre-Colau M, Rannou F, Quintero N, Nys A, Mace Y . Relation of inflammatory modic changes to intradiscal steroid injection outcome in chronic low back pain. Eur Spine J. 2007; 16(7):925-31. PMC: 2219668. DOI: 10.1007/s00586-006-0301-y. View

14.

Modic M, Masaryk T, Ross J, Carter J . Imaging of degenerative disk disease. Radiology. 1988; 168(1):177-86. DOI: 10.1148/radiology.168.1.3289089. View

15.

Mitra D, Cassar-Pullicino V, McCall I . Longitudinal study of vertebral type-1 end-plate changes on MR of the lumbar spine. Eur Radiol. 2004; 14(9):1574-81. DOI: 10.1007/s00330-004-2314-4. View

16.

Ricart O, Serwier J . [Dynamic stabilisation and compression without fusion using Dynesys for the treatment of degenerative lumbar spondylolisthesis: a prospective series of 25 cases]. Rev Chir Orthop Reparatrice Appar Mot. 2008; 94(7):619-27. DOI: 10.1016/j.rco.2008.04.015. View

17.

Sandhu H, Parvataneni H, Cammisa Jr F, Girardi F, Ghelman B . Association between findings of provocative discography and vertebral endplate signal changes as seen on MRI. J Spinal Disord. 2000; 13(5):438-43. DOI: 10.1097/00002517-200010000-00012. View

18.

Schilling C, Kruger S, Grupp T, Duda G, Blomer W, Rohlmann A . The effect of design parameters of dynamic pedicle screw systems on kinematics and load bearing: an in vitro study. Eur Spine J. 2010; 20(2):297-307. PMC: 3030714. DOI: 10.1007/s00586-010-1620-6. View

19.

Zucherman J, Hsu K, Picetti 3rd G, White A, WYNNE G, Taylor L . Clinical efficacy of spinal instrumentation in lumbar degenerative disc disease. Spine (Phila Pa 1976). 1992; 17(7):834-7. DOI: 10.1097/00007632-199207000-00018. View

20.

Braithwaite I, White J, Saifuddin A, Renton P, Taylor B . Vertebral end-plate (Modic) changes on lumbar spine MRI: correlation with pain reproduction at lumbar discography. Eur Spine J. 1998; 7(5):363-8. PMC: 3611292. DOI: 10.1007/s005860050091. View