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腰椎融合术与非融合术对 Modic 改变发展的影响。

The effects of lumbar fusion and non-fusion surgery on the development of Modic changes.

机构信息

Department of Spine Surgery, The People's Hospital of Guangxi Zhuang Autonomous Region, Guangxi Academy of Medical Sciences, No. 6, Taoyuan Road, Nanning, 530021, Guangxi, China.

Department of Neurosurgery, Justus-Liebig-University, Giessen, Germany.

出版信息

J Orthop Surg Res. 2022 Jul 1;17(1):89. doi: 10.1186/s13018-022-02971-3.

Abstract

BACKGROUND

The aim of this study was to investigate the influence of lumbar fusion and non-fusion surgery on the postoperative development of Modic changes (MCs).

METHODS

A total of 270 patients who underwent lumbar fusion, microsequestrectomy, microdiscectomy, and microdecompression, and who were examined by pre- and postoperative magnetic resonance imaging during the period of January 2012 to December 2018, were included in this retrospective study. The incidence of new postoperative MCs and the change of volume of preexisting MCs after surgery were investigated.

RESULTS

The total incidence of new MCs following lumbar surgical procedures was 36.3%. Lumbar fusion showed a tendency towards a lower postoperative incidence of new MCs than the other three lumbar surgical procedures. The first postoperative year seems to be the most active phase for the development of new MCs. The postoperative volumes of MCs in patients who underwent lumbar non-fusion procedures were significantly greater than those before surgery (P < 0.01). However, no significant difference was detected between pre- and postoperative volumes of MCs in patients with lumbar fusion (P > 0.05).

CONCLUSION

Lumbar surgical procedures contribute to the development of new MCs, particularly non-fusion surgeries. However, further studies are needed to confirm the clinical relevance of these findings.

摘要

背景

本研究旨在探讨腰椎融合与非融合手术对术后 Modic 改变(MCs)发展的影响。

方法

回顾性分析 2012 年 1 月至 2018 年 12 月期间接受腰椎融合、微切除、微椎间盘切除术和微减压术,并在术前和术后通过磁共振成像检查的 270 例患者。研究调查了新术后 MCs 的发生率和术后原有 MCs 体积的变化。

结果

腰椎手术后新 MCs 的总发生率为 36.3%。腰椎融合术与其他三种腰椎手术相比,术后新发 MCs 的发生率有降低的趋势。术后第一年似乎是新 MCs 发展最活跃的阶段。接受腰椎非融合手术的患者术后 MCs 体积明显大于术前(P<0.01)。然而,接受腰椎融合术的患者术后 MCs 体积与术前相比无显著差异(P>0.05)。

结论

腰椎手术会导致新的 MCs 的形成,特别是非融合手术。然而,需要进一步的研究来证实这些发现的临床意义。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1ef4/9248197/20669ed55422/13018_2022_2971_Fig1_HTML.jpg

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