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Abstract：
OBJECTIVE: At present, the influence of Modic changes (MCs) on postoperative fusion rate of lumbar interbody fusion (LIF) is mainly focused on the medium- and long-term fusion rate, while the short-term fusion rate has not been reported. The aim of this study was to compare the short-term fusion rate of lumbar degenerative disease patients with and without MCs after single level transforaminal lumbar interbody fusion (TLIF).
METHODS: In this retrospective and matched-pair case control study, we included 100 patients who underwent TLIF from January 2017 to January 2020 and had at least two follow-up visits over a two-year period. Fifty patients with MCs (MCs group) were matched with 50 patients without MCs (non MCs group) for age, sex, surgical level, diagnosis, operative time, and intraoperative blood loss. We collected the X-ray and computed tomography (CT) data of patients from 3 months to 2 years after the operation to assess bony fusion and the cage union ratio. According to the type of cage, the MCs group was further divided into the nano-hydroxyapatite/polyamide 66 (n-HA/PA66) group and polyetheretherketone (PEEK) group, and the fusion performance between the two groups was compared. Finally, age, sex, body mass index (BMI), smoking and cage type were included in the logistic regression model for risk factor analysis.
RESULTS: The bony fusion rates in the MCs group at 3 months, 6 months, 1 year and 2 years after surgery were significantly lower than those in the non MCs group (P < 0.05) (23.8% vs 62.5%, 52.6% vs 78.9%, 61.1% vs 83.3%, 74.0% vs 90.0%). The average coronal cage union ratios of the upper and lower endplates in the MCs group were significantly lower than those in the non MCs group (54.3% ± 17.5% vs 75.0% ± 17.2%, P < 0.05; 73.3% ± 12.0% vs 84.9% ± 8.0%, P < 0.05). Similarly, analogous results were obtained by comparing the MCs and non MCs groups\' three-dimensional CT sagittal plane images (62.5% ± 16.5% vs 76.1% ± 12.4%, P < 0.05; 67.0% ± 13.9% vs 79.8% ± 11.5%, P < 0.05).
CONCLUSIONS: Short-term fusion rates were lower in the MCs group than in the non MCs group. The coronal and sagittal cage union ratio in the MCs group was lower than that in the non MCs group. The fusion performance of n-HA/PA66 and PEEK cages in the MCs group was comparable.
METHODS: In this retrospective and matched-pair case control study, we included 100 patients who underwent TLIF from January 2017 to January 2020 and had at least two follow-up visits over a two-year period. Fifty patients with MCs (MCs group) were matched with 50 patients without MCs (non MCs group) for age, sex, surgical level, diagnosis, operative time, and intraoperative blood loss. We collected the X-ray and computed tomography (CT) data of patients from 3 months to 2 years after the operation to assess bony fusion and the cage union ratio. According to the type of cage, the MCs group was further divided into the nano-hydroxyapatite/polyamide 66 (n-HA/PA66) group and polyetheretherketone (PEEK) group, and the fusion performance between the two groups was compared. Finally, age, sex, body mass index (BMI), smoking and cage type were included in the logistic regression model for risk factor analysis.
RESULTS: The bony fusion rates in the MCs group at 3 months, 6 months, 1 year and 2 years after surgery were significantly lower than those in the non MCs group (P < 0.05) (23.8% vs 62.5%, 52.6% vs 78.9%, 61.1% vs 83.3%, 74.0% vs 90.0%). The average coronal cage union ratios of the upper and lower endplates in the MCs group were significantly lower than those in the non MCs group (54.3% ± 17.5% vs 75.0% ± 17.2%, P < 0.05; 73.3% ± 12.0% vs 84.9% ± 8.0%, P < 0.05). Similarly, analogous results were obtained by comparing the MCs and non MCs groups\' three-dimensional CT sagittal plane images (62.5% ± 16.5% vs 76.1% ± 12.4%, P < 0.05; 67.0% ± 13.9% vs 79.8% ± 11.5%, P < 0.05).
CONCLUSIONS: Short-term fusion rates were lower in the MCs group than in the non MCs group. The coronal and sagittal cage union ratio in the MCs group was lower than that in the non MCs group. The fusion performance of n-HA/PA66 and PEEK cages in the MCs group was comparable.
摘要：
目标：目前，Modic改变(MCs)对腰椎椎间融合术(LIF)术后融合率的影响主要集中在中远期融合率,而短期融合率尚未报道。这项研究的目的是比较有和没有MC的腰椎退行性疾病患者在单水平经椎间孔腰椎椎间融合术（TLIF）后的短期融合率。
方法：在这项回顾性配对病例对照研究中，我们纳入了2017年1月至2020年1月接受TLIF治疗的100例患者,这些患者在2年期间接受了至少2次随访.50例MCs患者(MCs组)与50例无MCs患者(非MCs组)年龄相匹配,性别,手术水平，诊断,手术时间,术中失血。我们收集了患者术后3个月至2年的X射线和计算机断层扫描（CT）数据，以评估骨融合和笼子愈合率。根据笼子的类型,MCs组又分为纳米羟基磷灰石/聚酰胺66(n-HA/PA66)组和聚醚醚酮(PEEK)组,比较两组的融合性能。最后,年龄,性别,体重指数（BMI），吸烟和笼型被纳入危险因素分析的logistic回归模型.
结果：MC组3个月时的骨融合率，6个月,术后1年和2年显著低于非MCs组(P<0.05)(23.8%vs62.5%,52.6%vs78.9%，61.1%vs83.3%，74.0%vs90.0%）。MCs组上下终板的平均冠状笼结合率明显低于非MCs组(54.3%±17.5%vs75.0%±17.2%,P<0.05；73.3%±12.0%vs84.9%±8.0%，P<0.05)。同样，通过比较MCs和非MCs组的三维CT矢状面图像获得了类似的结果(62.5%±16.5%vs76.1%±12.4%，P<0.05；67.0%±13.9%vs79.8%±11.5%，P<0.05)。
结论：MC组的短期融合率低于非MC组。MCs组的冠状位和矢状位融合率低于非MCs组。MCs组中n-HA/PA66和PEEK笼的融合性能相当。
方法：在这项回顾性配对病例对照研究中，我们纳入了2017年1月至2020年1月接受TLIF治疗的100例患者,这些患者在2年期间接受了至少2次随访.50例MCs患者(MCs组)与50例无MCs患者(非MCs组)年龄相匹配,性别,手术水平，诊断,手术时间,术中失血。我们收集了患者术后3个月至2年的X射线和计算机断层扫描（CT）数据，以评估骨融合和笼子愈合率。根据笼子的类型,MCs组又分为纳米羟基磷灰石/聚酰胺66(n-HA/PA66)组和聚醚醚酮(PEEK)组,比较两组的融合性能。最后,年龄,性别,体重指数（BMI），吸烟和笼型被纳入危险因素分析的logistic回归模型.
结果：MC组3个月时的骨融合率，6个月,术后1年和2年显著低于非MCs组(P<0.05)(23.8%vs62.5%,52.6%vs78.9%，61.1%vs83.3%，74.0%vs90.0%）。MCs组上下终板的平均冠状笼结合率明显低于非MCs组(54.3%±17.5%vs75.0%±17.2%,P<0.05；73.3%±12.0%vs84.9%±8.0%，P<0.05)。同样，通过比较MCs和非MCs组的三维CT矢状面图像获得了类似的结果(62.5%±16.5%vs76.1%±12.4%，P<0.05；67.0%±13.9%vs79.8%±11.5%，P<0.05)。
结论：MC组的短期融合率低于非MC组。MCs组的冠状位和矢状位融合率低于非MCs组。MCs组中n-HA/PA66和PEEK笼的融合性能相当。
