outcome of spondylolisthesis patients with and without modic changes operated by pedicle screw

Abstract

Lumbar spondylolisthesis is a relatively common causes of low back and leg pain. Despite the high prevalence of modic changes, the role of these changes and their importance in the spinal fusion process have not been well studied and the available data, are very contradictory. The purpose of this study is to investigate role of modic changes in the surgical outcomes of patients with spondylolisthesis who undergo posterolateral fusion with pedicle screw Method and materials: In this randomized controlled trial, 83 patients with degenerative spondylolisthesis with or without modic changes referred to Imam Reza Hospital in Tabriz. The severity of low back pain was determined based on visual analogue scale (VAS) and to assess functional disability Japanese orthopedic association score (joa) was. patients were divided into three groups: 1- Modic 0 N= 35 patients 2- Modic I N= 26 patients 3- Modic II N=22 patients. surgery outcome was calculated based on VAS and JOAS criteria, which were observed during the initial follow-up period two weeks after surgery, and the final follow-up between 6 months to one year after surgery. Results: The mean age of 83 patients participating in the study was 9.11 ± 57.01 years. 57 patients were grade 1 and 26 were grade 2 spondylolisthesis. There was no association between spondylosis grade and the presence or absence of modic changes. X² = 2.017 and P value = 0.15 VAS of patients before fusion surgery was 7.48 ± 1.50 and JOA of patients before fusion surgery was 5.06 ± 1.62. there is no significant difference in study groups. During the initial follow-up, the VAS level decreased significantly to 4.27 ± 2.01. (P value = 0.000 ) and the JOA level increased significantly to 8.06 ±1.79 (P value = 0.0001) In the final follow-up period, the VAS and JOA were 2.23 ± 1.56 and 11.29 ± 1.89, respectively. There was no significant difference between the study groups.