title: Does disk space degeneration according to Los Angeles and Modic scales have relation with recurrent disk herniation?
abstract: BACKGROUND
  After single disk herniation operation, about 5-20% recurrences may occur. Different etiology may affect the prevalence of recurrence. Disk degeneration according to Modic and Los Angles scales could affect recurrence rate. This study wants to show the relationship between disk space degeneration according to these scales on severity, time, and prevalence of disk herniation recurrence.
  
  
  METHODS
  Thirty-four patients presented with radicular pain (with or without back pain) and history of lumbar disk surgery was included in this prospective study. Pre- and postoperative T2-weighted sagittal magnetic resonance imaging (MRI) compared for Modic and Los Angeles disk degeneration grading, then, data analysis on SPSS (version 20) software, paired t-test, and others.
  
  
  RESULTS
  The result of study shows for first operation that grade (II) Los Angeles is the most common, but, for second procedure grade (IV) was less common and the mostly decreased (from 14.7 to 9.2%). In addition, Wilcoxon test shows no change of Los Angeles grading for both first and second surgery (P = 0.06). Whereas; based on Modic criteria grading was different from first operation, in other words, grade (I) (41.2%) in first operation was changed to 20.6% in second operation (P = 0.007).
  
  
  CONCLUSIONS
  Our study showed that the Los Angeles criterion is more practical and useful for prediction of recurrence and in the patients with Los Angles grade III and IV and grade II and III on Modic scale, the chance of recurrence is less than patients with lower grades.
authors.affiliation: Department of Neurosurgery, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Saied
authors.initials: S
authors.lastname: Abrishamkar
authors.affiliation: Department of Neurosurgery, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Mehdi
authors.initials: M
authors.lastname: Mahmoudkhani
authors.affiliation: Department of Neurosurgery, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Bahram
authors.initials: B
authors.lastname: Aminmansour
authors.affiliation: Department of Neurosurgery, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Amir
authors.initials: A
authors.lastname: Mahabadi
authors.affiliation: Department of Neurosurgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Shohreh
authors.initials: S
authors.lastname: Jafari
keywords: Disk herniation recurrence; Los Angeles scale; Modic scale; disc space degeneration