Abstract
Introduction: In this study we describe Modic changes within treated-lumbar disc levels and levels adjacent-to-Dynamic Neutralisation System for the Spine (Dynesys).
Modic changes(M) have been described in association to Degenerative Disc Disease(DDD). Type-I represents the inflammatory phase whereas Type-II describes fatty changes within the vertebral marrow and endplate. Type-III is more advanced degeneration and it indicates marked sclerosis adjacent to endplates.
Material & Methods: Postoperative MRI has been compared to preoperative scan in 28 symptomatic patients treated with Dynesys. Parameters assessed were Modic changes within treated disc levels and their adjacent segments. Average time to postoperative MRI was 36 months with a range of 17–66 months.
Results: Within Dynesys-treated levels; 16 levels had no Modic change preoperatively of which 13 remained unchanged while 3 developed M2 with treatment. 15 had M2, of which, 7 worsen to M3, 6 continued as M2 and 2 improved to M0. 12 had M3, of which 1 improved to M1 and the rest did not change.
Adjacent endplate levels showed worsening of M0 to M2 in 11 patients while no change was seen in 35 levels. Only 4 levels with M2 were seen, of which 3 levels did not change and 1 level continued to M3. 2 M3 improved to M2.
Discussion & Conclusion: Compared to recently published studies by Danish group, Modic changes have the tendancy to worsen on conservative treatment. In this study we could show that following Dynesys progress of Modic changes at the treated level(s) was not remarkable though few cases continued with the process of degeneration.
Correspondence should be addressed to SBPR at the Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PE, England.
