title: [Surgical options and clinical outcomes in patients of lumbar disc herniation with Modic changes].
abstract: OBJECTIVE
  To retrospectively evaluate medium and long-term outcomes of conventional fenestration discectomy versus posterior lumbar interbody fusion in lumbar disc herniation with Modic changes.
  
  
  METHODS
  From January 2002 to January 2007, a total of 486 patients of lumbar disc herniation with Modic changes were analyzed retrospectively. They were divided into fenestration group (n = 215) and fusion group (n = 271) according to the operative approaches. The scores of Oswestry disability index (ODI) and visual analog scale (VAS) pre-and post-operative 3, 6, 12 month and annually were recorded and analyzed.
  
  
  RESULTS
  All of them had complete records during a mean follow-up period of 88.9 (60-120) months. At the end of the latest follow-up, all symptoms were relieved postoperatively. Significantly difference existed in the improvement rate of back pain VAS between two groups (77.9% vs 68.0%). In the fenestration group, the improvement rate of VAS (back pain) of Modic type I I was better than that of Modic type I (72.8% vs 64.9%). And the difference was statistically significant. For those with Modic type I changes, the improvement rate of ODI and VAS (back pain) of the fusion group were better than those of the fenestration group (78.3% vs 70.4% and 77.4% vs 64.9%). And the differences were statistically significant (P < 0.05).
  
  
  CONCLUSIONS
  The patients with Modic I and II changes were recommended to undergo lumbar fusion and undergo fenestration discectomy respectively.
authors.affiliation: Department of Spinal Surgery, Tianjin Hospital, Tianjin 300211, China. Email: doczhaodong@yahoo.com.cn.
authors.forename: Dong
authors.initials: D
authors.lastname: Zhao
authors.affiliation: Department of Spinal Surgery, Tianjin Hospital, Tianjin 300211, China.
authors.forename: Shu-cai
authors.initials: SC
authors.lastname: Deng
authors.affiliation: Department of Spinal Surgery, Tianjin Hospital, Tianjin 300211, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Ma
authors.affiliation: Department of Spinal Surgery, Tianjin Hospital, Tianjin 300211, China.
authors.forename: Yong-hong
authors.initials: YH
authors.lastname: Hao
authors.affiliation: Department of Spinal Surgery, Tianjin Hospital, Tianjin 300211, China.
authors.forename: Zhan-hua
authors.initials: ZH
authors.lastname: Jia
authors.affiliation: Department of Spinal Surgery, Tianjin Hospital, Tianjin 300211, China.
authors.forename: He-yuan
authors.initials: HY
authors.lastname: Zhao
mesh_terms: D000328:Adult; D017586:Diskectomy / Q000379:methods*; D005260:Female; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000601:surgery*; D008159:Lumbar Vertebrae; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013123:Spinal Fusion; D016896:Treatment Outcome; D055815:Young Adult