• Peter Muhareb Udby, Søren Ohrt-Nissen, Tom Bendix, Rune Paulsen, Christian Støttrup, Andreas Andresen, Stig Brorson, Leah Y Carreon, and Mikkel Østerheden Andersen.
• Spine Unit, Department of Orthopedic Surgery, Zealand University Hospital, Køge, Denmark.
• Spine. 2020 Nov 1; 45 (21): 149114971491-1497.

Study DesignA registry-based comparative cohort study with 2-year follow-up.ObjectiveTo assess whether Modic changes (MCs) are associated with health-related quality of life, long-term physical disability, back- or leg pain after discectomy.Summary Of Background DataPrevious studies have failed to show a clinically significant association between MCs and patient-reported outcomes (PROs) after discectomy.MethodsData from the Danish National Spine Registry on patients undergoing first-time lumbar discectomy at a single institution from 2014 to 2017 with an accessible preoperative lumbar magnetic resonance imaging, complete preoperative, and 2-year follow-up questionnaires were obtained. PROs including Oswestry disability index (ODI), European Quality of Life-Five Dimensions (EQ-5D), visual analogue scale (VAS) back and leg pain, and patient satisfaction were collected. Patients were stratified based on the presence (+MC) or absence (-MC) of MCs on the preoperative MRI.ResultsOf 620 patients included, MCs were present in 290 patients (47%). Of these, MC type 1 (MC-1) was present in 73 (25%) and MC type 2 (MC-2) in 217 (75%) patients. Preoperative data for ODI, EQ-5D, VAS-BP, and VAS-LP were comparable for the +MC and -MC groups. Both groups had a statistically significant improvement in PROs from baseline compared with 2-year follow-up (P < 0.001). At 2-year follow-up, both groups had improved with no significant difference between them in regards to ODI (15.5 vs. 17.2, P = 0.208); EQ-5D (0.75 vs. 0.72, P = 0.167); VAS-BP (27.1 vs. 28.3, P = 0.617); VAS-LP (26.8 vs. 25.0, P = 0.446); and patient satisfaction (74% vs. 76%, P = 0.878).ConclusionMCs were not found to be associated with health-related quality of life, disability, back- or leg pain, or patient satisfaction 2 years after discectomy.Level Of Evidence2.

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