Role of Lumbar Fusion in Modic Degenerative Changes Type 1

Background: Modic changes (MC), which are categorized into three kinds based on their MRI signal patterns, are degenerative alterations of the vertebral end plates and surrounding bone marrow that are frequently linked to lumbar spine degenerative disc disease (DDD). Because of the mechanical failure and structural alterations that are most noticeable in the area of the extremely pain-sensitive intervertebral endplates, MC are implicated in the development of low back pain (LBP). Objective: We examined how treating lumbar disc herniation patients with preoperative MR images demonstrating MC type I affected the management of postoperative LBP and functional outcome when fusion was added to simple discectomy. Methods: This retrospective study was conducted upon 15 patients at Beni-Suef University Hospital between March 2023 and March 2024. We evaluated the results of 15 patients who had lumbar intervertebral disc herniation-related LBP and sciatica surgically treated, together with the concurrent presence of MC type I in the preoperative MRI. Patients underwent posterior spinal fusion (PSF) and laminectomy. Preoperative MRI was used to establish the MC Type. Before and three months following surgery, the VAS was used to gauge the level of discomfort. Results: The study was conducted upon 15 patients whose ages were between 30-65 years old with a mean 45.5. The study included 9 males and 6 females. LBP was the most common presenting symptom in all participants, followed by sciatica or claudication pain in 83.3%. Changes in VAS from before to after surgery were recorded. Results showed a statistically significant improvement in back pain after surgery when comparing preoperative VAS values using a paired student-t test, with a p-value of less than 0.001 for both sets of data. Conclusion: Surgical therapy for LBP with MC type I leads to considerable pain relief. PSF seems to be a superior therapy for patients with MC type I.