Evidence map›Paper›PMID 39778044›Full record

ArticleOrthopaedic surgery2025

Pear-Shaped Disc as a Risk Factor for Postoperative Sclerotic Modic Changes After Transforaminal Lumbar Interbody Fusion.

Yang Xiao, Wenbin Shuai, Zhuang Zhang, Limin Liu, Yueming Song, Xi Yang

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Article in Orthopaedic surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

Authors and funding

6 authors.

Yang XiaoDepartment of Orthopaedic, Orthopaedic Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan, China.ORCID https://orcid.org/0000-0002-0216-1129
Wenbin ShuaiDepartment of Anesthesiology and Operating Room, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Zhuang ZhangDepartment of Orthopaedic, Orthopaedic Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan, China.ORCID https://orcid.org/0000-0002-3279-9262
Limin LiuDepartment of Orthopaedic, Orthopaedic Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Yueming SongDepartment of Orthopaedic, Orthopaedic Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan, China.ORCID https://orcid.org/0000-0002-2377-0740
Xi YangDepartment of Orthopaedic, Orthopaedic Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan, China.ORCID https://orcid.org/0000-0001-7925-3323

Funding

Science and Technology Department of Sichuan Province 2021YFG0240
6 · The paper itself

Abstract

objectivePear-shaped disc could increase the risk of intraoperative end-plate injury, which may lead to postoperative sclerotic Modic Changes (MCs). However, there are no studies on the relationship between pear-shaped disc and postoperative sclerotic MCs. Therefore, this study investigates the risk factors for postoperative sclerotic MCs following transforaminal lumbar interbody fusion (TLIF). Specifically, the study focuses on the impact of pear-shaped disc on the occurrence of postoperative sclerotic MCs and evaluates its influence on clinical outcomes.

methodsA total of 411 patients undergoing TLIF between January 2018 and January 2022 were included. Among them, 50 developed postoperative sclerotic MCs, while 361 did not. The two groups were matched based on various parameters. Clinical and radiographic evaluations, including visual analogue scale (VAS), Oswestry disability index (ODI), lumbar X-ray, CT, and MRI, were performed. Statistical analysis included independent sample t test, Pearson's chi-square test, and binary logistic regression analysis.

resultsAfter pairing, a total of 100 patients were included, including 50 patients in postoperative sclerotic MCs group and 50 patients in non-MCs group. There were 27 pear-shaped discs in the postoperative sclerotic MCs group, significantly higher than 7 in the non-MCs group (p < 0.001). Besides, BMI, endplate injury, and cage subsidence in the postoperative sclerotic MCs group were significantly higher than those in the non-MCs group, but the fusion rate was significantly lower than that in the non-MCs group. The postoperative and follow-up SL and surgical corrections of SL in postoperative sclerotic MCs group were significantly higher than those in non-MCs group. The independent risk factors identified for postoperative sclerotic MCs include pear-shaped disc and higher BMI.

conclusionPear-shaped disc and higher body mass index (BMI) as independent risk factors for postoperative sclerotic MCs. Patients with sclerotic MCs exhibited a lower fusion rate, increased cage subsidence, and poorer symptom improvement compared to those without MCs.

Indexed as

Intervertebral DiscLumbar VertebraePostoperative ComplicationsSpinal FusionAdultAgedFemaleHumansMaleMiddle AgedRetrospective StudiesRisk FactorsSclerosisEndplate–cage mismatchLumbar degenerative diseasePear‐shaped discPostoperative sclerotic Modic changesTransforaminal lumbar interbody fusion

Identifiers

PMID39778044
PMCPMC11962282

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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.