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Does disk space degeneration according to Los Angeles and Modic scales have relation with recurrent disk herniation?

Abrishamkar S, Mahmoudkhani M, Aminmansour B, Mahabadi A, Jafari S - Adv Biomed Res (2014)

Bottom Line: Pre- and postoperative T2-weighted sagittal magnetic resonance imaging (MRI) compared for Modic and Los Angeles disk degeneration grading, then, data analysis on SPSS (version 20) software, paired t-test, and others.The result of study shows for first operation that grade (II) Los Angeles is the most common, but, for second procedure grade (IV) was less common and the mostly decreased (from 14.7 to 9.2%).Our study showed that the Los Angeles criterion is more practical and useful for prediction of recurrence and in the patients with Los Angles grade III and IV and grade II and III on Modic scale, the chance of recurrence is less than patients with lower grades.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, Isfahan University of Medical Sciences, Isfahan, Iran.

ABSTRACT

Background: After single disk herniation operation, about 5-20% recurrences may occur. Different etiology may affect the prevalence of recurrence. Disk degeneration according to Modic and Los Angles scales could affect recurrence rate. This study wants to show the relationship between disk space degeneration according to these scales on severity, time, and prevalence of disk herniation recurrence.

Materials and methods: Thirty-four patients presented with radicular pain (with or without back pain) and history of lumbar disk surgery was included in this prospective study. Pre- and postoperative T2-weighted sagittal magnetic resonance imaging (MRI) compared for Modic and Los Angeles disk degeneration grading, then, data analysis on SPSS (version 20) software, paired t-test, and others.

Results: The result of study shows for first operation that grade (II) Los Angeles is the most common, but, for second procedure grade (IV) was less common and the mostly decreased (from 14.7 to 9.2%). In addition, Wilcoxon test shows no change of Los Angeles grading for both first and second surgery (P = 0.06). Whereas; based on Modic criteria grading was different from first operation, in other words, grade (I) (41.2%) in first operation was changed to 20.6% in second operation (P = 0.007).

Conclusion: Our study showed that the Los Angeles criterion is more practical and useful for prediction of recurrence and in the patients with Los Angles grade III and IV and grade II and III on Modic scale, the chance of recurrence is less than patients with lower grades.

No MeSH data available.


Related in: MedlinePlus

Mid, range, and percentile 25 and 75 of radicular pain before first and secondary operation
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Figure 1: Mid, range, and percentile 25 and 75 of radicular pain before first and secondary operation

Mentions: Level of operation was L4-5 in 15 patients (44.1%), L3-4 in four patients (11.8%), and L5-S1 in 15 patients (44.1%). Side of operation was right at 17 patient and left at 17 patients. Type of operation was hemilaminectomy in nine patients and foraminotomy in 25 patients. Median time from beginning of radicular pain and primary operation was 5.1 ± 2.2 months with range of 2–10 months. Median time of radicular pain at secondary operation was 4.2 ± 1.2 with range of 2–6 months and based on paired t-test, there was significant difference in the first and second surgery time (P = 0.04) [Table 3]. In Figure 1, the distribution of radicular pain time in two operations is shown. Upon t-test and analysis of covariance, none of these variable elements was effective on incidence of recurrent radicular leg pain (P > 0.05).


Does disk space degeneration according to Los Angeles and Modic scales have relation with recurrent disk herniation?

Abrishamkar S, Mahmoudkhani M, Aminmansour B, Mahabadi A, Jafari S - Adv Biomed Res (2014)

Mid, range, and percentile 25 and 75 of radicular pain before first and secondary operation
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4260280&req=5

Figure 1: Mid, range, and percentile 25 and 75 of radicular pain before first and secondary operation
Mentions: Level of operation was L4-5 in 15 patients (44.1%), L3-4 in four patients (11.8%), and L5-S1 in 15 patients (44.1%). Side of operation was right at 17 patient and left at 17 patients. Type of operation was hemilaminectomy in nine patients and foraminotomy in 25 patients. Median time from beginning of radicular pain and primary operation was 5.1 ± 2.2 months with range of 2–10 months. Median time of radicular pain at secondary operation was 4.2 ± 1.2 with range of 2–6 months and based on paired t-test, there was significant difference in the first and second surgery time (P = 0.04) [Table 3]. In Figure 1, the distribution of radicular pain time in two operations is shown. Upon t-test and analysis of covariance, none of these variable elements was effective on incidence of recurrent radicular leg pain (P > 0.05).

Bottom Line: Pre- and postoperative T2-weighted sagittal magnetic resonance imaging (MRI) compared for Modic and Los Angeles disk degeneration grading, then, data analysis on SPSS (version 20) software, paired t-test, and others.The result of study shows for first operation that grade (II) Los Angeles is the most common, but, for second procedure grade (IV) was less common and the mostly decreased (from 14.7 to 9.2%).Our study showed that the Los Angeles criterion is more practical and useful for prediction of recurrence and in the patients with Los Angles grade III and IV and grade II and III on Modic scale, the chance of recurrence is less than patients with lower grades.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, Isfahan University of Medical Sciences, Isfahan, Iran.

ABSTRACT

Background: After single disk herniation operation, about 5-20% recurrences may occur. Different etiology may affect the prevalence of recurrence. Disk degeneration according to Modic and Los Angles scales could affect recurrence rate. This study wants to show the relationship between disk space degeneration according to these scales on severity, time, and prevalence of disk herniation recurrence.

Materials and methods: Thirty-four patients presented with radicular pain (with or without back pain) and history of lumbar disk surgery was included in this prospective study. Pre- and postoperative T2-weighted sagittal magnetic resonance imaging (MRI) compared for Modic and Los Angeles disk degeneration grading, then, data analysis on SPSS (version 20) software, paired t-test, and others.

Results: The result of study shows for first operation that grade (II) Los Angeles is the most common, but, for second procedure grade (IV) was less common and the mostly decreased (from 14.7 to 9.2%). In addition, Wilcoxon test shows no change of Los Angeles grading for both first and second surgery (P = 0.06). Whereas; based on Modic criteria grading was different from first operation, in other words, grade (I) (41.2%) in first operation was changed to 20.6% in second operation (P = 0.007).

Conclusion: Our study showed that the Los Angeles criterion is more practical and useful for prediction of recurrence and in the patients with Los Angles grade III and IV and grade II and III on Modic scale, the chance of recurrence is less than patients with lower grades.

No MeSH data available.


Related in: MedlinePlus