Outcome of pedicle screw surgery in spondylolisthesis patients with and without modic changes

Lumbar spondylosthesis is a relatively common complication. This study was designed and conducted with the aim of investigating the role of Modic changes in the surgical results of patients with spondylolisthesis who undergo posterolateral fusion with pedicle screws. In this prospective cohort study, 83 patients diagnosed with degenerative spondylolisthesis with or without Modic changes and candidates for posterolateral fusion surgery with pedicle screws were included. The patients were divided into three groups: Modic 0, 35 people; Modic I, 26 people; and Modic II, 22 people. The surgical outcome was determined based on the visual analogue scale (VAS) and Oswestry Disability Index (ODI) criteria. The average age of patients in the group with and without Modic changes is 56.97 ± 7.03 and 58.00 ± 9.38, respectively ( P- value = 0.58). There was no relationship between the grade of spondylolisthesis and the presence or absence of Modic changes ( P -value = 0.15). The VAS of the patients before the fusion operation was 7.48 ± 1.50, and ODI of the patients before the fusion operation was 69.62 ± 5.06, which did not have a significant difference between the study groups. In the initial follow-up period, the VAS level decreased significantly and reached 4.27 ± 2.01. ( P -value = 0.001). And the amount of ODI decreased significantly, reaching 49.79 ± 5.06. ( P -value = 0.0001) In the final follow-up period, the VAS and ODI were 1.56 ± 2.23 and 39.29 ± 2.89, respectively, indicating that there was no significant difference between the studied groups. The present study showed no statistically significant difference in surgical outcomes (VAS and ODI) among patients with degenerative spondylolisthesis undergoing posterolateral fusion with or without Modic changes. Further large-scale prospective studies are warranted to validate these results. Level 1 (higher quality of evidence) • No VAS score difference seen between Modic types 0, 1, and 2 pre-surgery. • No ODI score difference noted across Modic types before spinal fusion surgery. • VAS score differed significantly between spondylolisthesis grades 1 and 2. • No link found between Modic type and surgical outcome based on VAS or ODI. • VAS and ODI scores stable from initial to final follow-up regardless of Modic type.