Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Neurosurgery

Background: Modic changes (MC), visible on magnetic resonance imaging (MRI), are associated with chronic low back pain (LBP). It is reported that different MC types could affect the surgical outcome in patients with LBP. Objective: The aim of the study is to evaluate the effect of preoperative Modic Changes on the outcome of patients with LBP due to degenerative disc disease following Posterior spinal fusion (PSF) with laminectomy or laminectomy alone. Methods: This prospective study was conducted upon 30 patients at Cairo University Hospitals and Beni-suef university hospital starting in March 2020 to be completed in October 2020. We evaluated the outcome of 30 patients with LBP and MC Type I and II who underwent laminectomy (n = 15) or PSF (n = 15). Preoperative MRI was used to define MC types. Visual analog scale (VAS) was used to evaluate the pain intensity before and 3 months after surgery. Results: The study was conducted upon 30 Patients between 30 to 65 years old with a mean 45.5. 17 were males and 13 were females. The most common presenting symptom was Low back pain in all patients, followed by claudication pain in 83.3%. Preoperative to postoperative (VAS) changes were documented in our study. Regarding the type I Modic changes, Pain VAS improved immediately post- operative after both laminectomy only 2group A3 and laminectomy with PSF 2group B3 with mean ± SD 3.5 and 2.29 points for group A, B respectively. While Pain VAS 3 months post-operative, patients who underwent management in group B improved more than those who underwent management in group A with mean ±SD 1.14 ±0.69 which is statistically significant with P value= 0.008. Regarding type II Modic changes, Pain VAS improved immediate post-operative and 3 months post-operative in both groups with no significant difference in values

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