Evidence map›Paper›PMID 32157388›Full record

ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2020

The influence of endplate (Modic) changes on clinical outcomes in lumbar spinal stenosis surgery: a Swiss prospective multicenter cohort study.

Nils H Ulrich, Jakob M Burgstaller, Isaac Gravestock, Sebastian Winklhofer, François Porchet, Giuseppe Pichierri, Maria M Wertli, Johann Steurer, Mazda Farshad, LSOS Study Group

Abstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in 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, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 2 pooled it
1.0field-weighted citation impact, top 25% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 2 syntheses or guidelines pooled it, 13 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 1 institution in 1 country.

Nils H UlrichHorten Centre for Patient Oriented Research and Knowledge Transfer, University of Zurich, Zurich, Switzerland. nils.hb.ulrich@gmail.com.
Jakob M BurgstallerHorten Centre for Patient Oriented Research and Knowledge Transfer, University of Zurich, Zurich, Switzerland.
Isaac GravestockHorten Centre for Patient Oriented Research and Knowledge Transfer, University of Zurich, Zurich, Switzerland.
Sebastian WinklhoferInstitute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
François PorchetDepartment of Orthopedics and Neurosurgery, Spine Center, Schulthess Clinic, Zurich, Switzerland.
Giuseppe PichierriHorten Centre for Patient Oriented Research and Knowledge Transfer, University of Zurich, Zurich, Switzerland.
Maria M WertliHorten Centre for Patient Oriented Research and Knowledge Transfer, University of Zurich, Zurich, Switzerland.
Johann SteurerHorten Centre for Patient Oriented Research and Knowledge Transfer, University of Zurich, Zurich, Switzerland.
Mazda FarshadUniversity Spine Centre Zurich, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.
LSOS Study Group
University of Zurich · CH

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo investigate if the presence or absence of preoperative endplate Modic changes (MC) is predictive for clinical outcomes in degenerative lumbar spinal stenosis (DLSS) patients undergoing decompression-alone or decompression with instrumented fusion surgery.

methodsTwo hundred five patients were included and categorized into four groups; 102 patients into the decompression-alone group with MCs, 41 patients into the fusion group with MCs, 46 patients into the decompression-alone group without MCs, and 16 patients into the fusion group without MCs. Clinical outcome was quantified with changes in spinal stenosis measure (SSM) symptoms, SSM function, NRS pain, and EQ-5D-3L sum score over time (measured at baseline, 12-, 24-, and 36-month follow-up) and minimal clinically important difference (MCID) in SSM symptoms, SSM function, and NRS pain from baseline to 36-month follow-up. To investigate if possible effects of MCs had been modified or hidden by confounding variables, we used the group LASSO method to search for good prognostic models.

resultsThere were no obvious differences in any of the clinical outcome measures between groups at baseline. At 12 months, most patients have improved in all outcomes and maintained improved conditions over time (no significant group differences). Between 70 and 90 percent of the patients maintained a clinically important improvement up to 36 months.

conclusionsEndplate MCs have no significant influence on clinical outcome parameters in patients with lumbar spinal stenosis compared to patients without MCs, independent of the chosen surgical strategy. All patients benefitted from surgical therapy up to 36-month follow-up. These slides can be retrieved under Electronic Supplementary Material.

Indexed as

Spinal FusionSpinal StenosisDecompression, SurgicalHumansLumbar VertebraeProspective StudiesSwitzerlandTreatment OutcomeDecompressionDegenerative lumbar spinal stenosisEndplateFusionModic changes

Identifiers

PMID32157388
OpenAlexW3011186327

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.