Clinical and radiographic outcomes of hybrid graft in patients with Modic changes undergoing transforaminal lumbar interbody fusion

Journal of Orthopaedic Surgery and Research

Jiaxun Jiao¹  Jiaqi Li²  Wei Zhang²  Yun Luo² 

[1] Department of Spinal Surgery, Harrison International Peace Hospital, 053000, Hengshui, Hebei, People’s Republic of China;Department of Spinal Surgery, The Third Hospital of Hebei Medical University, 050051, Shijiazhuang, People’s Republic of China;The Key Laboratory of Orthopedic Biomechanics of Hebei Province, The Third Hospital of Hebei Medical University, 050051, Shijiazhuang, People’s Republic of China;Department of Spinal Surgery, The Third Hospital of Hebei Medical University, 050051, Shijiazhuang, People’s Republic of China;The Key Laboratory of Orthopedic Biomechanics of Hebei Province, The Third Hospital of Hebei Medical University, 050051, Shijiazhuang, People’s Republic of China;

关键词: Modic changes;    Transforaminal lumbar interbody fusion;    Autologous local bone graft;    Allogeneic freeze-dried bone graft;    Fusion;    Outcomes;   

DOI  :  10.1186/s13018-021-02652-7

来源: Springer

【 摘 要 】

BackgroundThis retrospective study aimed to analyze the influence of Modic changes (MCs) on the clinical and radiographic outcomes of transforaminal lumbar interbody fusion with hybrid graft.MethodsClinical data of 89 patients with Modic changes who underwent single-segment transforaminal lumbar interbody fusion between January 2015 and January 2019 at our institution were analyzed. Patients were divided into three groups: the MCs-0 group (no endplate changes; used as the control group), the MCs-1 group, and the MCs-2 group. Clinical and radiological parameters were compared between the three groups.ResultsThere were no significant between-group differences in age (P = 0.216), sex (P = 0.903), body mass index (P = 0.805), smoking (P = 0.722), diagnosis (P = 0.758), surgical level (P = 0.760), blood loss (P = 0.172), operative time (P = 0.236), or follow-up (P = 0.372). Serum C-reactive protein level and erythrocyte sedimentation rate in the MCs-1 and MCs-2 groups were significantly higher than those in the MCs-0 group on the third and seventh days (P < 0.05). Postoperative radiographic parameters were significantly higher than preoperative parameters in all 3 groups (P < 0.05). Visual analog scale scores for low back pain in the MCs-0 and MCs-2 groups were significantly different from those in the MCs-1 group (P < 0.05). However, there were no significant between-group differences with respect to Oswestry Disability Index scores or visual analog scale scores for leg pain.ConclusionIn this study, Modic changes had no impact on fusion rates and clinical outcomes of transforaminal lumbar interbody fusion with hybrid graft (autologous local bone graft plus allogeneic freeze-dried bone graft). However, MCs-1 increased the risk of cage subsidence and showed superior outcomes in terms of visual analog scale scores for low back pain.

【 授权许可】

CC BY