Effect of Preoperative Modic Change in the Outcome of Patients with Low Back Pain Following Posterior Spinal Fusion or Laminectomy

BACKGROUND: Modic changes (MC), visible on magnetic resonance imaging (MRI) are associated with chronic low back pain (LBP). It is reported that different MC types could affect the surgical outcome in patients with LBP. OBJECTIVE: In this study, we evaluated the effect of MC Type I and II on patients with LBP and degenerative disc disease following posterior spinal fusion (PSF) or laminectomy. MATERIALS AND METHODS: We evaluated the outcome of 162 patients with LBP and MC Type I and II who underwent laminectomy (n = 72) or PSF (n = 90). Preoperative MRI was used to define MC types. Visual analog scale (VAS) was used to evaluate the pain intensity before and 3 months after surgery. RESULTS: Patients had MC Type I in 46.3% and Type II in 53.7%. Pain VAS significantly decreased following surgery (7.93 ± 1.27–5.98 ± 1.57, P < 0.001). There was no difference between MC Type I and II in pain VAS before (P = 0.51) and after treatment (P = 0.51). Among MC Type I, PSF compared to laminectomy had significantly more improvement in pain VAS (P = 0.01), but the changes in modic Type II were similar between groups (P = 0.89). CONCLUSION: Surgical treatment in patients with LBP with MC accompanies with significant improvement in pain. PSF seems better treatment in patients with MC Type I.