ArticleSpine2013
Magnetic resonance imaging predictors of surgical outcome in patients with lumbar intervertebral disc herniation.
Article in Spine, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
33 citing papers in PubMed, 4 syntheses or guidelines pooled it, 65 citations in OpenAlex.
- Evaluating the Impact of Modic Changes on Operative Treatment in the Cervical and Lumbar Spine: A Systematic Review and Meta-Analysis.International journal of environmental research and public health · 2022Pooled it
- Pathobiology of Modic changes.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2016Pooled it
- Do Modic changes have an impact on clinical outcome in lumbar spine surgery? A systematic literature review.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2016Pooled it
- Systematic literature review of imaging features of spinal degeneration in asymptomatic populations.AJNR. American journal of neuroradiology · 2015Pooled it
- Associations between preoperative biomarkers and patient-reported outcomes after single-level lumbar discectomy: a systematic review.Journal of spine surgery (Hong Kong) · 2026Review
- Adjacent segment degeneration may predict significantly worse leg pain outcomes after lumbar discectomy.Skeletal radiology · 2026Article
- Patient selection, clinical outcomes, associated healthcare utilization, and cost-effectiveness of basivertebral nerve ablation for the treatment of vertebrogenic low back pain: A narrative review.North American Spine Society journal · 2025Article
- Characteristics of endplate changes in patients with lumbar disc herniation treated by discectomy and their effects on clinical symptoms during one-year postoperative follow-up.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2025Article
- Indications for surgery versus conservative treatment in the management of lumbar disc herniations: A systematic review.Brain & spine · 2025Review
- Intradiscal administration of autologous platelet-rich plasma in patients with Modic type 1 associated low back pain: A prospective pilot study.JOR spine · 2024Article
- Comparison of Clinical and Radiographic Outcomes Between Transforaminal Endoscopic Lumbar Discectomy and Microdiscectomy: A Follow-up Exceeding 5 Years.Neurospine · 2024Article
- Lumbar endplate microfracture injury induces Modic-like changes, intervertebral disc degeneration and spinal cord sensitization - an in vivo rat model.The spine journal : official journal of the North American Spine Society · 2023Article
- Lumbar endplate microfracture injury induces Modic-like changes, intervertebral disc degeneration and spinal cord sensitization - An In Vivo Rat Model.bioRxiv : the preprint server for biology · 2023Article
- Analysis of the Efficacy of Percutaneous Endoscopic Interlaminar Discectomy for Lumbar Disc Herniation with Different Types/Grades of Modic Changes.Journal of pain research · 2023Article
- Magnetic Resonance Imaging Characteristics Associated with Treatment Success from Basivertebral Nerve Ablation: An Aggregated Cohort Study of Multicenter Prospective Clinical Trials Data.Pain medicine (Malden, Mass.) · 2022Article
- Ex vivo biomechanical evaluation of Acute lumbar endplate injury and comparison to annulus fibrosus injury in a rat model.Journal of the mechanical behavior of biomedical materials · 2022Article
- Lumbar Disc Herniation and Preoperative Modic Changes: A Prospective Analysis of the Clinical Outcomes After Microdiscectomy.Global spine journal · 2022Article
- Presence of preoperative Modic changes and severity of endplate damage score are independent risk factors for developing postoperative surgical site infection: a retrospective case-control study of 1124 patients.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2021Article
- Caudal Lumbar Disc Herniations Are More Likely to Require Surgery for Symptom Resolution.Global spine journal · 2021Article
- Comparison of Percutaneous Transforaminal Endoscopic Decompression and Transforaminal Lumbar Interbody Fusion in the Treatment of Single-Level Lumbar Disc Herniation with Modic Type I Changes.Journal of pain research · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 5 institutions in 1 country.
Funding
Abstract
STUDY
designA retrospective cohort design.
objectiveTo determine whether baseline magnetic resonance imaging findings, including central/foraminal stenosis, Modic change, disc morphology, facet arthropathy, disc degeneration, nerve root impingement, and thecal sac compression, are associated with differential surgical treatment effect. SUMMARY OF BACKGROUND DATA: Intervertebral disc herniation remains the most common source of lumbar radiculopathy treated either with discectomy or nonoperative intervention. Although magnetic resonance imaging remains the reliable "gold standard" for diagnosis, uncertainty surrounds the relationship between magnetic resonance imaging findings and treatment outcomes.
methodsThree hundred seven "complete" images from patients enrolled in a previous trial were de-identified and evaluated by 1 of 4 independent readers. Findings were compared with outcome measures including the Oswestry Disability Index. Differences in surgery and nonoperative treatment outcomes were evaluated between image characteristic subgroups and TE determined by the difference in Oswestry Disability Index scores.
resultsThe cohort comprised 40% females with an average age of 41.5 (±11.6) years, 61% of whom underwent discectomy for intervertebral disc herniation. Patients undergoing surgery with Modic type I endplate changes had worse outcomes (-26.4 vs. -39.7 for none and -39.2 for type 2, P = 0.002) and smaller treatment effect (-3.5 vs. -19.3 for none and -15.7 for type 2, P = 0.003). Those with compression of ≥1/3 showed the greatest improvement within the surgical group (-41.9 for ≥1/3 vs. -31.6 for none and -38.1 for <1/3, P = 0.007) and the highest TE (-23 compared with -11.7 for none and -15.2 for <1/3, P = 0.015). Furthermore, patients with minimal nerve root impingement demonstrated worse surgical outcomes (-26.5 vs. -41.1 for "displaced" and -38.9 for "compressed," P = 0.016).
conclusionAmong patients with intervertebral disc herniation, those with thecal sac compression of 1/3 or more had greater surgical treatment effect than those with small disc herniations and Modic type I changes. In addition, patients with nerve root "compression" and "displacement" benefit more from surgery than those with minimal nerve root impingement. LEVEL OF EVIDENCE: 2.
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