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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

Distribution of Modics scales before first and second operation
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Figure 2: Distribution of Modics scales before first and second operation

Mentions: In Figures 2 and 3 distribution of prevalence upon Modics and Los Angeles scale has been shown. Before the first operation, 14 patients (41.2%) had Modics grade I, 12 (35.3%) and eight (23.5%) were in grade II and III, respectively; but after recurrence seven (20.6%), 17 (50%), and ten (29.4%) have been changed to grade I, II, and III, respectively. According to Los Angeles criteria, before the first surgery ten patients (29.4%) had grade I, 14 (41.2%) had grade II, six (17.6%) had grade III, 4 (11.7%) had grade IV, and none had grade V; however, before secondary operation, six (17.6%), 16 (47.1%), six (17.6%), three (8.8%), and three (8.8%) patients had grade I, II, III, IV, and V, respectively. Modics criteria's grading differed from first to second surgery as incidence of grade I changed from 41.2 to 20.6% (P = 0.007). However, Los Angeles scale did not show significant difference (P = 0.06).


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)

Distribution of Modics scales before first and second operation
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 2: Distribution of Modics scales before first and second operation
Mentions: In Figures 2 and 3 distribution of prevalence upon Modics and Los Angeles scale has been shown. Before the first operation, 14 patients (41.2%) had Modics grade I, 12 (35.3%) and eight (23.5%) were in grade II and III, respectively; but after recurrence seven (20.6%), 17 (50%), and ten (29.4%) have been changed to grade I, II, and III, respectively. According to Los Angeles criteria, before the first surgery ten patients (29.4%) had grade I, 14 (41.2%) had grade II, six (17.6%) had grade III, 4 (11.7%) had grade IV, and none had grade V; however, before secondary operation, six (17.6%), 16 (47.1%), six (17.6%), three (8.8%), and three (8.8%) patients had grade I, II, III, IV, and V, respectively. Modics criteria's grading differed from first to second surgery as incidence of grade I changed from 41.2 to 20.6% (P = 0.007). However, Los Angeles scale did not show significant difference (P = 0.06).

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