Evaluating the Impact of Modic Changes on Operative Treatment in the Cervical and Lumbar Spine: A Systematic Review and Meta-Analysis

Mark J. Lambrechts (), Parker Brush, Tariq Z. Issa, Gregory R. Toci, Jeremy C. Heard, Amit Syal, Meghan M. Schilken, Jose A. Canseco, Christopher K. Kepler and Alexander R. Vaccaro
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Mark J. Lambrechts: Rothman Orthopedic Institute, Thomas Jefferson University, Philadelphia, PA 19107, USA
Parker Brush: Rothman Orthopedic Institute, Thomas Jefferson University, Philadelphia, PA 19107, USA
Tariq Z. Issa: Rothman Orthopedic Institute, Thomas Jefferson University, Philadelphia, PA 19107, USA
Gregory R. Toci: Rothman Orthopedic Institute, Thomas Jefferson University, Philadelphia, PA 19107, USA
Jeremy C. Heard: Rothman Orthopedic Institute, Thomas Jefferson University, Philadelphia, PA 19107, USA
Amit Syal: Rothman Orthopedic Institute, Thomas Jefferson University, Philadelphia, PA 19107, USA
Meghan M. Schilken: Rothman Orthopedic Institute, Thomas Jefferson University, Philadelphia, PA 19107, USA
Jose A. Canseco: Rothman Orthopedic Institute, Thomas Jefferson University, Philadelphia, PA 19107, USA
Christopher K. Kepler: Rothman Orthopedic Institute, Thomas Jefferson University, Philadelphia, PA 19107, USA
Alexander R. Vaccaro: Rothman Orthopedic Institute, Thomas Jefferson University, Philadelphia, PA 19107, USA

IJERPH, 2022, vol. 19, issue 16, 1-18

Abstract: Modic changes (MCs) are believed to be potential pain generators in the lumbar and cervical spine, but it is currently unclear if their presence affects postsurgical outcomes. We performed a systematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. All studies evaluating cervical or lumbar spine postsurgical outcomes in patients with documented preoperative MCs were included. A total of 29 studies and 6013 patients with 2688 of those patients having preoperative MCs were included. Eight included studies evaluated cervical spine surgery, eleven evaluated lumbar discectomies, nine studied lumbar fusion surgery, and three assessed lumbar disc replacements. The presence of cervical MCs did not impact the clinical outcomes in the cervical spine procedures. Moreover, most studies found that MCs did not significantly impact the clinical outcomes following lumbar fusion, lumbar discectomy, or lumbar disc replacement. A meta-analysis of the relevant data found no significant association between MCs and VAS back pain or ODI following lumbar discectomy. Similarly, there was no association between MCs and JOA or neck pain following ACDF procedures. Patients with MC experienced statistically significant improvements following lumbar or cervical spine surgery. The postoperative improvements were similar to patients without MCs in the cervical and lumbar spine.

Keywords: Modic changes; lumbar spine; cervical spine; patient reported outcomes; anterior cervical discectomy and fusion; lumbar fusion; discectomy (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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