Clinical analysis of low back pain in patients with lumbar degenerative disc disease with Modic I/II changes after percutaneous transforaminal endoscopic discectomy: a retrospective study

Abstract

Abstract Background Modic I/II has been associated with low back pain in some previous studies, but the majority of scholars still question this. This study investigated the changes of low back pain in patients with lumbar degenerative diseases and the recovery of low back and leg pain in patients after percutaneous transforaminal endoscopic lumbar discectomy (PTED) without fusion and decompression surgery alone. Methods Sixty-four patients (aged 57.86 ± 10.86 years) with lumbar degenerative diseases whose vertebral bone marrow showed Modic I/II signal were selected. All patients presented with low back and leg pain due to lumbar degeneration and underwent PTED without fusion. We evaluated changes in visual analogue scale (VAS) scores for low back pain and Oswestry disability index (ODI) before surgery, 1 month after surgery, 6 months after surgery, and 1 and 2 years after surgery. Results The mean age of the PTED group was 57.86 ± 10.86 years. The VAS leg, VAS back, and ODI scores were significantly improved after surgery compared with those before surgery. Notably, VAS back pain score and VAS leg pain score showed an increasing trend over time in the MCI group after PTED, and there were statistically significant differences in VAS back pain score and VAS leg pain score at 1 month and 2 years after surgery (P < 0.05). Conclusions PTED improves the condition of low back pain in patients with lumbar degenerative diseases. Low back pain in patients with lumbar degenerative diseases seems to arise primarily from nerve root compression, and the intuitive impact of MC on low back pain remains elusive. However, patients who presented with recurrent low back or leg pain within 2 years of surgery could be the result of progression of normal lumbar degeneration.