| Clinical Outcomes in Old Patients Showing Endplate Modic Change with Lumbar Disc Herniation after Lumbar Discectomy |
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Jae-Chang Lee , Jung-Yul Park , Jang-Bo Lee , Tae-Hyung Cho , Joong-Keun Seo |
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Department of Neurosurgery, Korea University School of Medicine, Medical Center, Anam, Korea |
| 자기공명영상 상 척추 종판의 이상 변화를 보인 노인 추간판탈출증 환자에서 추간판제거술 후의 임상 결과 |
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이재창ㆍ박정율ㆍ이장보ㆍ조태형ㆍ서중근 |
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고려대학교 의과대학 신경외과학교실 |
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| Abstract |
Objective
The purpose of this study was to evaluate the change in low back pain in old patients with lumbar disc herniation and abnormalities of the vertebral endplate after lumbar discectomy.
Methods
70 old patients with lumbar disc herniation showing normal and Modic type 1, 2 signals in their bone marrow were selected. All patients had low back pain because of lumbar disc herniation, and underwent posterior discectomy without fusion surgery. Before and 2 years after surgery, the Visual analogue scale (VAS) score and Oswestry Disability Index (ODI) were recorded and compared three groups.
Results
33 patients showed Modic type 1 signals, 32 patients showed Modic type 2 signals, 30 patients showed normal intensity before surgery. VAS score and ODI were not significantly different before surgery (p=0.120 for VAS score, p=0.131 for ODI). After surgery, VAS score and ODI significantly improved in all groups (p<0.01). VAS score and ODI after surgery were not significantly different in three groups (p=0.110 for VAS score, p=0.125 for ODI).
Conclusion
Discectomy improved low back pain in old patients suffering from lumbar disc herniation. Even though the patients showed abnormal change in bone marrow, their low back pain score similarly improved compared with that in the patents without Modic sgnal changes in their bone marrow. We concluded that low back pain in the patients with disc herniation mainly originates from disc or nerve root compression, and decompression surgery without fusion is an option for these patients. |
| Key Words:
Low back painㆍModic changeㆍEndplateㆍDisc herniationㆍDiscectomyㆍOld patientㆍMagnetic resonance imaging |
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