A Comparative Study Of The Effect Of Modic ? Changes In Lumbar Endplate On The Intervertebral Fusion Rate After Transforminal Lumbar Interbody Fusion

Objectives The purpose of this study is to clarify the research progress and clinical significance of lumbar endplate Modic changes,To analyze the effect of Modic II changes in the lumbar endplate on the short term interbody fusion rate after transforaminal lumbar interbody fusion(TLIF).The rate of short-term interbody fusion after different segments of the low lumbar spine was compared.Materials and Methods A retrospective analysis of patients with lumbar posterior fusion performed in Yinchuan Guolong Hospital from September 2015 to October 2017,A total of 80 patients were followed(control group + Modic type II changes group)and were reviewed at 1?3? 6?9and 12 months after surgery.All lumbar X-ray films showed solid internal fixation at 6 months postoperatively.The intervertebral cage was not displaced and the intervertebral height was maintained well.The sagittal reconstructive CT of the lumbar spine at 6 months postoperatively showed a grade II interbody fusion rate of 21/36(58.3%)and a grade III interbody fusion rate of 15/36(41.6%)with the Modic type II changes group.The grade II interbody fusion rate was 36/44(81.8%)in patients without Modic type II alterations,and 6/44(13.6%)in grade III interbody fusions.transforaminal lumbar interbody fusion(TLIF)was performed in both groups.Two groups of basic data were collected for follow-up.The intervertebral fusion rate was compared between the two groups at 6 months after operation,to investigate the effect of Modic ? changes on postoperative short-term interbody fusion rate.Results A total of 80 patients(control group + experimental group)were followed up.Two patients in the control group had surgical incision fat liquefaction,One patient in the control group(without Modic II change)and 2 patients in the experimental group(with Modic II change)presented with lower extremity venous thrombosis and recovered after treatment.Postoperative review was performed at the prescribed time.All patients were followed up for 6 months.All the lumbar X-ray films showed a good fixation,the cage was not displaced and the intervertebral height was maintained well.In the Six months after operation,the two groups of lumbar reconstruction CT showed that no fusion was found.In the control group,two cases were completely fused.the grade ? intervertebral fusion rate in group A(control group)was 36/44(81.8%),and the level ? intervertebral fusion rate was 6/44(13.6%).In group B(modic ?),grade ? intervertebral fusion rate was 21/36(58.3%),and grade ? intervertebral fusion rate was 15/36(41.6%).The operative time(p = 0.316),intraoperative blood loss(p = 0.671),age(p = 0.263),gender(p = 0.877),However,there was a significant difference in the rate of II intervertebral fusion between the two groups after surgery(p =0.039),There was also a significant difference in grade ? intervertebral fusion rate(p = 0.010).Patients with Modic ? changesgroup had lower interbody fusion rate at 6 months after operation.Conclusions The short-term interbody fusion rate after transforaminal lumbar interbody fusion(TLIF)was slightly worse in patients with lumbar endplates with Modic type II changes than in patients with no lumbar end plate without Modic type II changes,Modic II changes in the lumbar end plate may be one of the important factors affecting the short-term interbody fusion rate after TLIF.