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• W2132227720 abstract "To assess the predictive value of MRI vertebral end-plate changes (Modic) on clinical outcome of surgically treated lumbar single-level degenerative disc disease (DDD). A cohort of 60 patients was included. Patient groups were similar in respect of age, gender and clinical presentation, allowing comparisons. Patient age ranged from 30 to 72 years (mean: 45.8 years). All patients suffered severe chronic low back pain for more than 6 months, with single-level symptomatic DDD. All patients experienced segmental instrumented interbody (n=22) or posterolateral (n=38) fusion. Clinical outcome was assessed by using a visual analog scale (VAS) and the functional disability scale of the Japanese Orthopaedic Association (JOA) for lumbar spine. The number of patients for each Modic group was as follows: Modic type 0, n=15; Modic type I, n=22; Modic type II, n=14; and Modic type I/II, n=9. Fusion rates were similar for each Modic group of patients. Mean follow-up was 14 months. The pre-operative mean VAS improved by 53.5% (from 8.2±2.0 to 3.8±1.9, p<0.05) and the pre-operative mean JOA score by 58% (from 5.5±2.1 to 11.0±2.4, p < 0.05). Patients harboring Modic type I changes improved much better than others (p<0.05). Conversely, clinical outcome of patients presenting with Modic type II lesions was poor. This study confirms instrumented fusion as an effective treatment in symptomatic lumbar DDD. Preoperative combination of low back pain of discal origin and severe DDD with Modic type I lesion on MRI may lead to excellent results after fusion in a large proportion of patients. Conversely, arthrodesis for patients harboring Modic type II abnormalities implicates smaller benefit of doubtful clinical significance. Évaluer la valeur pronostique de la classification de Modic des patients opérés d’une discopathie dégénérative symptomatique. Étude de cohorte incluant 60 patients souffrant de lombalgies discales sévères évoluant depuis plus de 6 mois. Le traitement chirurgical a consisté en une arthrodèse instrumentée monosegmentaire dans tous les cas. Critères d’évaluation clinique: EVA: échelle fonctionnelle de la JOA. Répartition des lésions Modic dans la série: Modic 0: n = 15; Modic I: n = 22; Modic II: n = 14; Modic I/II: n = 9. Les différents groupes de patients étaient comparables en termes de caractéristiques anthropométriques. La qualité de la fusion a été évaluée au terme du suivi en utilisant les critères radiologiques de Brantigan et Steffee. Tous les résultats ont été recueillis par un observateur indépendant. Les comparaisons statistiques ont été effectuées à l’aide du test de Mann-Whitney, avec un risque de 5%. Le suivi moyen était de 14 mois. Les taux de fusion étaient comparables pour chaque groupe de malades. L’EVA a été améliorée de 53,5% (de 8,2 ± 2,0 à 3,8 ± 1,9, p < 0,05). Le score JOA a été amélioré de 58% (de 5,5 ± 2,1 à 11,0 ± 2,4, p < 0,05). Les patients porteurs de lésions de type Modic I ont eu un bénéfice fonctionnel supérieur aux autres groupes (p < 0,05). À l’inverse, les Modic II ont été peu ou pas améliorés par le traitement chirurgical. Cette série confirme l’intérêt de l’arthrodèse instrumentée dans le traitement des discopathies douloureuses. L’IRM préopératoire constitue un facteur pronostique essentiel. Nous pensons qu’au vu de ces résultats, la présence de lésions de type Modic II doit inciter à la plus grande prudence quant à l’indication chirurgicale." @default.
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• W2132227720 date "2006-09-01" @default.
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• W2132227720 title "Predictive value of MRI vertebral end-plate signal changes (MODIC) on outcome of surgically treated degenerative disc disease" @default.
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• W2132227720 doi "https://doi.org/10.1016/s0028-3770(06)71225-5" @default.
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