ArticleInternational journal of spine surgery2021
Modic Changes on Magnetic Resonance Imaging and Smoking History Predict Vascular Adherence During Anterior Lumbar Exposure.
Article in International journal of spine surgery, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
What it found
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Who cites it
4 citing papers in PubMed.
- Lumbar interbody fusion via anterior lumbar interbody fusion versus oblique lumbar interbody fusion versus lateral lumbar interbody fusion: a narrative review for surgeons.Journal of spine surgery (Hong Kong) · 2025Review
- Endplate remodeling: a key indicator of cigarette smoke exposure-induced intervertebral disc degeneration in a male rat model.JBMR plus · 2025Article
- Effect of cigarette smoke exposure and cessation on regional diffusion properties in rat intervertebral discs.JOR spine · 2024Article
- Who bleeds during elective anterior lumbar surgery?North American Spine Society journal · 2022Article
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAnterior approaches to surgically access the lumbar intervertebral discs are associated with a risk of developing major vascular injury and bleeding. The likelihood of injury increases in the presence of dense adherence between the disc annulus, vertebral periosteum, and vessels, which result from reactive inflammatory changes that cause fibrous scarring.
objectiveTo identify factors that predict vascular adherence, which may facilitate preoperative planning and technique modifications for anterior spine surgery. STUDY
designProspective study examining patients undergoing anterior retroperitoneal exposure for lumbar disc surgery.
methodsA total of 246 consecutive patients were enrolled in this study, all of whom had anterior retroperitoneal exposure for lumbar disc surgery. Patient demographics, smoking status, magnetic resonance imaging (MRI) findings, operative parameters, and dissection difficulty associated with vascular adherence were recorded. Current smokers were defined as those who smoked at the time of surgery or had ceased smoking <6 months before the operation. Patients were excluded if they were morbidly obese or had previously undergone anterior spine surgery or radiotherapy.
resultsA multivariate regression analysis identified 2 significant risk factors for difficult dissections that are complicated by vascular adhesion: Modic Type 2 changes on MRI (
conclusionsModic Type 2 changes on MRI and any smoking history can predict the adherence of large blood vessels to the anterior disc annulus, which enhances the difficulty of the dissection. These predictors could indicate to spinal surgeons that the patient has a 2-fold increased risk of vascular adherence. CLINICAL RELEVANCE: Modic Type 2 changes on MRI and any smoking history can predict the adherence of large blood vessels to the anterior disc annulus, which enhances the difficulty of the dissection. These predictors could indicate to spinal surgeons that the patient has a 2-fold increased risk of vascular adherence during anterior lumbar exposure. LEVEL OF EVIDENCE: 3.
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