• Dong Zhao, Shu-cai Deng, Yi Ma, Yong-hong Hao, Zhan-hua Jia, and He-yuan Zhao.
• Department of Spinal Surgery, Tianjin Hospital, Tianjin 300211, China. Email: doczhaodong@yahoo.com.cn.
• Zhonghua Yi Xue Za Zhi. 2013 Oct 22;93(39):3111-5.

ObjectiveTo retrospectively evaluate medium and long-term outcomes of conventional fenestration discectomy versus posterior lumbar interbody fusion in lumbar disc herniation with Modic changes.MethodsFrom January 2002 to January 2007, a total of 486 patients of lumbar disc herniation with Modic changes were analyzed retrospectively. They were divided into fenestration group (n = 215) and fusion group (n = 271) according to the operative approaches. The scores of Oswestry disability index (ODI) and visual analog scale (VAS) pre-and post-operative 3, 6, 12 month and annually were recorded and analyzed.ResultsAll of them had complete records during a mean follow-up period of 88.9 (60-120) months. At the end of the latest follow-up, all symptoms were relieved postoperatively. Significantly difference existed in the improvement rate of back pain VAS between two groups (77.9% vs 68.0%). In the fenestration group, the improvement rate of VAS (back pain) of Modic type I I was better than that of Modic type I (72.8% vs 64.9%). And the difference was statistically significant. For those with Modic type I changes, the improvement rate of ODI and VAS (back pain) of the fusion group were better than those of the fenestration group (78.3% vs 70.4% and 77.4% vs 64.9%). And the differences were statistically significant (P < 0.05).ConclusionThe patients with Modic I and II changes were recommended to undergo lumbar fusion and undergo fenestration discectomy respectively.

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