Spine Unit, Department of Orthopedic Surgery, Zealand University Hospital, Køge, Denmark.
Center for Rheumatology and Spine Diseases, Rigshospitalet/University of Copenhagen, København, Denmark.
Spine (Phila Pa 1976). 2020 Nov 1;45(21):1491-1497. doi: 10.1097/BRS.0000000000003618.
A registry-based comparative cohort study with 2-year follow-up.
To assess whether Modic changes (MCs) are associated with health-related quality of life, long-term physical disability, back- or leg pain after discectomy.
Previous studies have failed to show a clinically significant association between MCs and patient-reported outcomes (PROs) after discectomy.
Data from the Danish National Spine Registry on patients undergoing first-time lumbar discectomy at a single institution from 2014 to 2017 with an accessible preoperative lumbar magnetic resonance imaging, complete preoperative, and 2-year follow-up questionnaires were obtained. PROs including Oswestry disability index (ODI), European Quality of Life-Five Dimensions (EQ-5D), visual analogue scale (VAS) back and leg pain, and patient satisfaction were collected. Patients were stratified based on the presence (+MC) or absence (-MC) of MCs on the preoperative MRI.
Of 620 patients included, MCs were present in 290 patients (47%). Of these, MC type 1 (MC-1) was present in 73 (25%) and MC type 2 (MC-2) in 217 (75%) patients. Preoperative data for ODI, EQ-5D, VAS-BP, and VAS-LP were comparable for the +MC and -MC groups. Both groups had a statistically significant improvement in PROs from baseline compared with 2-year follow-up (P < 0.001). At 2-year follow-up, both groups had improved with no significant difference between them in regards to ODI (15.5 vs. 17.2, P = 0.208); EQ-5D (0.75 vs. 0.72, P = 0.167); VAS-BP (27.1 vs. 28.3, P = 0.617); VAS-LP (26.8 vs. 25.0, P = 0.446); and patient satisfaction (74% vs. 76%, P = 0.878).
MCs were not found to be associated with health-related quality of life, disability, back- or leg pain, or patient satisfaction 2 years after discectomy.
一项基于登记的对比队列研究，随访时间为 2 年。
评估 Modic 改变（MCs）与椎间盘切除术后患者的健康相关生活质量、长期身体残疾、腰背或下肢疼痛之间的关系。
先前的研究未能显示 MCs 与椎间盘切除术后患者报告的结果（PROs）之间存在具有临床意义的关联。
从丹麦国家脊柱登记处获取了 2014 年至 2017 年在一家机构接受首次腰椎间盘切除术的患者数据，这些患者术前均有腰椎磁共振成像可供查阅，术前和 2 年随访时均完成了完整的调查问卷。PROs 包括 Oswestry 残疾指数（ODI）、欧洲五维健康量表（EQ-5D）、视觉模拟量表（VAS）腰背疼痛和患者满意度。根据术前 MRI 上 MCs 的存在（+MC）或不存在（-MC）对患者进行分层。
在纳入的 620 名患者中，290 名（47%）存在 MCs。其中，MC 1 型（MC-1）患者 73 名（25%），MC 2 型（MC-2）患者 217 名（75%）。+MC 组和 -MC 组患者术前 ODI、EQ-5D、VAS-BP 和 VAS-LP 数据无统计学差异。与基线相比，两组患者在 PROs 方面均有统计学显著改善（P<0.001）。在 2 年随访时，两组患者均有改善，两组之间 ODI（15.5 对 17.2，P=0.208）、EQ-5D（0.75 对 0.72，P=0.167）、VAS-BP（27.1 对 28.3，P=0.617）、VAS-LP（26.8 对 25.0，P=0.446）和患者满意度（74%对 76%，P=0.878）均无统计学差异。
椎间盘切除术后 2 年，MCs 与健康相关生活质量、残疾、腰背或下肢疼痛或患者满意度之间无关联。
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