Minimally Invasive Transforaminal Lumbar Interbody Fusion for Lumbar Disc Lesion with Modic Changes
|Yasuhito Kaneko1, Ken Ishii2*, Masaya Nakamura2, Takahiro Koyanagi3 and Morio Matsumoto2|
|1Department of Orthopaedic Surgery, Saitama City Hospital, Saitama, Japan, Keio Spine Research Group (KSRG), The Society for Minimally Invasive spine Stabilization (MISt), Japan|
|2Department of Orthopaedic Surgery, School of Medicine, Keio University, Tokyo, Japan, Keio Spine Research Group (KSRG), The Society for Minimally Invasive spine Stabilization (MISt), Japan|
|3Department of Orthopaedic Surgery, Kawasaki Municipal Kawasaki Hospital, Keio Spine Research Group (KSRG), Japan|
|*Corresponding Author :||Ken Ishii
Department of Orthopaedic Surgery
Keio University School of Medicine
Shinanomachi 35, Shinjuku-ku, Tokyo
E-mail: [email protected]
|Received: February 08, 2016 Accepted: February 19, 2016 Published: February 21, 2016|
|Citation: Kaneko Y, Ishii K, Nakamura M, Koyanagi T, Matsumoto M (2016) Minimally Invasive Transforaminal Lumbar Interbody Fusion for Lumbar Disc Lesion with Modic Changes. J Spine 5:289. doi:10.4172/2165-7939.1000289|
|Copyright: © 2016 Kaneko Y, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.|
Purpose: This study was conducted to assess short- to mid-range clinical outcomes of minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) for patients with severe low back pain caused by intervertebral disc degeneration showing Modic changes on MRI.
Methods: Thirty-five consecutive patients (mean age: 48.6 years) who underwent single-level MIS-TLIF to treat severe low back pain with Modic changes on MRI were included. Diagnoses were based on temporary pain relief after an intradiscal anesthetic injection, selective nerve blocking, or both. The mean follow-up period was 18 months. Japanese Orthopaedic Association (JOA) scores (29 possible points), JOA-score recovery rates (RR), Visual Analog Pain Scale (VAS) scores for low back pain, and the Oswestry Disability Index (ODI) were evaluated.
Results: The average JOA score improved significantly, from 14.8 ± 3.6 preoperatively to 26.9 ± 1.6 at the final follow-up (P < 0.01). The average JOA-score RR was 84.8 ± 11.7%. Significant improvements were obtained in the average VAS scores for low back pain (preoperative, 7.8 ± 1.9; final follow-up, 1.5 ± 0.7; P < 0.01) and ODI (preoperative, 57.9 ± 16.1; final follow-up, 13.0 ± 8.8; P < 0.01). Modic type 1 changes were observed in 12 patients, and type 2 changes in 23 patients. The JOA-score RR did not differ significantly between patients with Modic type 1 and type 2 (85.7% and 84.1%, respectively).
Conclusions: MIS-TLIF, which is less damaging to the paraspinal muscles than conventional approaches, is a reasonable surgical option for lumbar disc lesion with Modic type 1 and 2 changes.