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Recurrent disc herniation following percutaneous endoscopic lumbar discectomy preferentially occurs when Modic changes are present

OBJECTIVE: To investigate the relationship between Modic changes (MCs) and recurrent lumbar disc herniation (rLDH) and that between the herniated disc component and rLDH following percutaneous endoscopic lumbar discectomy (PELD). METHODS: We included 102 (65 males, 37 females, aged 20–66 years) inpa...

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Autores principales: Hao, Lu, Li, Shengwen, Liu, Junhui, Shan, Zhi, Fan, Shunwu, Zhao, Fengdong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7227219/
https://www.ncbi.nlm.nih.gov/pubmed/32410638
http://dx.doi.org/10.1186/s13018-020-01695-6
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author Hao, Lu
Li, Shengwen
Liu, Junhui
Shan, Zhi
Fan, Shunwu
Zhao, Fengdong
author_facet Hao, Lu
Li, Shengwen
Liu, Junhui
Shan, Zhi
Fan, Shunwu
Zhao, Fengdong
author_sort Hao, Lu
collection PubMed
description OBJECTIVE: To investigate the relationship between Modic changes (MCs) and recurrent lumbar disc herniation (rLDH) and that between the herniated disc component and rLDH following percutaneous endoscopic lumbar discectomy (PELD). METHODS: We included 102 (65 males, 37 females, aged 20–66 years) inpatients who underwent PELD from August 2013 to August 2016. All patients underwent CT and MRI preoperatively. The presence and type of Modic changes were assessed. During surgery, the herniated disc component of each patient was classified into two groups: nucleus pulposus group and hyaline cartilage group. The association of herniated disc component with Modic changes was investigated. The incidence of rLDH was assessed based on a more than 2-year follow-up. RESULTS: In total, 11 patients were lost to follow-up; the other 91 were followed up during 24–60 months. Of the 91 patients, 99 discs underwent PELD; 28/99 (28.3%) had MCs. Type I and II MCs were seen in 9 (9.1%) and 19 (19.2%), respectively; no type III MCs were found. Among 28 endplates with MCs, according to the herniated disc component, 18/28 (64.3%) showed evidence of hyaline cartilage in the intraoperative specimens, including 6/9 and 12/19 endplates with type I and II MCs, respectively. Among 71 endplates without MCs, 14/71 (19.7%) showed evidence of hyaline cartilage in the intraoperative specimens. Hyaline cartilage was more common in patients with MCs (P < 0.05). We found 2 cases of rLDH in the non-MC group (n = 71); 6 cases of rLDH were found in the MC group (n = 28), including 2 and 4 cases for types I and II, respectively. There was no significant difference between types I and II (P > 0.05). rLDH was more common in patients with MCs (P < 0.05). We found 5 rLDH cases in the hyaline cartilage group (n = 32); 3 rLDH cases were found in the nucleus pulposus group (n = 67). rLDH was more common in the hyaline cartilage group (P < 0.05). CONCLUSIONS: rLDH following PELD preferentially occurs when MCs or herniated cartilage are present.
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spelling pubmed-72272192020-05-27 Recurrent disc herniation following percutaneous endoscopic lumbar discectomy preferentially occurs when Modic changes are present Hao, Lu Li, Shengwen Liu, Junhui Shan, Zhi Fan, Shunwu Zhao, Fengdong J Orthop Surg Res Research Article OBJECTIVE: To investigate the relationship between Modic changes (MCs) and recurrent lumbar disc herniation (rLDH) and that between the herniated disc component and rLDH following percutaneous endoscopic lumbar discectomy (PELD). METHODS: We included 102 (65 males, 37 females, aged 20–66 years) inpatients who underwent PELD from August 2013 to August 2016. All patients underwent CT and MRI preoperatively. The presence and type of Modic changes were assessed. During surgery, the herniated disc component of each patient was classified into two groups: nucleus pulposus group and hyaline cartilage group. The association of herniated disc component with Modic changes was investigated. The incidence of rLDH was assessed based on a more than 2-year follow-up. RESULTS: In total, 11 patients were lost to follow-up; the other 91 were followed up during 24–60 months. Of the 91 patients, 99 discs underwent PELD; 28/99 (28.3%) had MCs. Type I and II MCs were seen in 9 (9.1%) and 19 (19.2%), respectively; no type III MCs were found. Among 28 endplates with MCs, according to the herniated disc component, 18/28 (64.3%) showed evidence of hyaline cartilage in the intraoperative specimens, including 6/9 and 12/19 endplates with type I and II MCs, respectively. Among 71 endplates without MCs, 14/71 (19.7%) showed evidence of hyaline cartilage in the intraoperative specimens. Hyaline cartilage was more common in patients with MCs (P < 0.05). We found 2 cases of rLDH in the non-MC group (n = 71); 6 cases of rLDH were found in the MC group (n = 28), including 2 and 4 cases for types I and II, respectively. There was no significant difference between types I and II (P > 0.05). rLDH was more common in patients with MCs (P < 0.05). We found 5 rLDH cases in the hyaline cartilage group (n = 32); 3 rLDH cases were found in the nucleus pulposus group (n = 67). rLDH was more common in the hyaline cartilage group (P < 0.05). CONCLUSIONS: rLDH following PELD preferentially occurs when MCs or herniated cartilage are present. BioMed Central 2020-05-14 /pmc/articles/PMC7227219/ /pubmed/32410638 http://dx.doi.org/10.1186/s13018-020-01695-6 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Hao, Lu
Li, Shengwen
Liu, Junhui
Shan, Zhi
Fan, Shunwu
Zhao, Fengdong
Recurrent disc herniation following percutaneous endoscopic lumbar discectomy preferentially occurs when Modic changes are present
title Recurrent disc herniation following percutaneous endoscopic lumbar discectomy preferentially occurs when Modic changes are present
title_full Recurrent disc herniation following percutaneous endoscopic lumbar discectomy preferentially occurs when Modic changes are present
title_fullStr Recurrent disc herniation following percutaneous endoscopic lumbar discectomy preferentially occurs when Modic changes are present
title_full_unstemmed Recurrent disc herniation following percutaneous endoscopic lumbar discectomy preferentially occurs when Modic changes are present
title_short Recurrent disc herniation following percutaneous endoscopic lumbar discectomy preferentially occurs when Modic changes are present
title_sort recurrent disc herniation following percutaneous endoscopic lumbar discectomy preferentially occurs when modic changes are present
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7227219/
https://www.ncbi.nlm.nih.gov/pubmed/32410638
http://dx.doi.org/10.1186/s13018-020-01695-6
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