The extent of intervertebral disc removal is associated with the occurrence of Modic change after percutaneous endoscopic transforaminal discectomy
- 1Department of Spine Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
Abstract
Background: Percutaneous endoscopic transforaminal discectomy (PETD) for lumbar disc herniation may increase the incidence of postoperative Modic change (PMC). However, whether variables reflecting the degree of intervertebral disc removal are associated with PMC is not yet investigated.
Methods: One hundred and sixty-seven patients with lumbar disc herniation who underwent PETD were divided into 2 groups according to the presence (PMC group) or absence (NPMC group) of Modic changes within 1 year postoperative follow-up. Preoperative demographic characteristics and perioperative imaging parameters were recorded and compared between the 2 groups. Further multivariate logistic regression analyses were performed for identifying confounding and independent influencing factors. Finally, receiver operating characteristic (ROC) curve analysis was employed to identify the optimal cutoff value of disc removal for the prediction of PMC.
Results: Fifty-two cases (31.1%) developed PMC. At 6 months postoperatively, the visual analogue scale (VAS) of the PMC group was significantly higher than that of the control group (p < .05). Logistic regression analysis showed that reduced preoperative intervertebral disc height (p = .003), large anterior-posterior diameter of the removed intervertebral disc (p = .018), and the intervertebral disc removed crossing the midline during surgery (p < .001), and the higher Pfirrmann grade (p < .001) were independent risk factors for the occurrence of PMC.
Conclusions: Our study identified an independent association between the extent of intervertebral disc resection during PETD and the incidence of PMC. A prospective study is warranted to investigate the effect of sufficient decompression without aggressive disc resection on postoperative Modic changes.
Related
- How reliable is percutaneous transforaminal endoscopic discectomy during the learning curve? A comparison of outcomes with microsurgical discectomy experiences
- The clinical efficacy of magnetic resonance neurography-assisted percutaneous transforaminal endoscopic discectomy.
- Two-Dimensional Electromagnetic Navigation-Assisted Percutaneous Transforaminal Endoscopic Discectomy for Lumbar Disc Herniation: A Retrospective Comparative Study.
- Comparison Between Interlaminar and Transforaminal Endoscopic Lumbar Discectomy for Sciatic Scoliosis Secondary to Lumbar Disc Herniation: A Retrospective Study With a Minimum 1 Year Follow‐Up
- Keyhole endoscopic resection of pediatric craniopharyngioma via a precoronal transventricular transforaminal approach: “small door, big win.”
BibTeX
@article{wang2026extent,
title = {{The extent of intervertebral disc removal is associated with the occurrence of Modic change after percutaneous endoscopic transforaminal discectomy}},
author = {Yida Wang and Hengsen Xu and Lei Li and Weihang Zhu and Ning Yu and Hao Zhang and Chao Wang},
journal = {North American Spine Society Journal},
year = {2026},
month = oct,
doi = {10.1016/j.xnsj.2026.100953},
url = {https://doi.org/10.1016/j.xnsj.2026.100953},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - The extent of intervertebral disc removal is associated with the occurrence of Modic change after percutaneous endoscopic transforaminal discectomy
AU - Yida Wang
AU - Hengsen Xu
AU - Lei Li
AU - Weihang Zhu
AU - Ning Yu
AU - Hao Zhang
AU - Chao Wang
PY - 2026
DA - 2026/10/06
JO - North American Spine Society Journal
DO - 10.1016/j.xnsj.2026.100953
UR - https://doi.org/10.1016/j.xnsj.2026.100953
AB - Background: Percutaneous endoscopic transforaminal discectomy (PETD) for lumbar disc herniation may increase the incidence of postoperative Modic change (PMC). However, whether variables reflecting the degree of intervertebral disc removal are associated with PMC is not yet investigated. Methods: One hundred and sixty-seven patients with lumbar disc herniation who underwent PETD were divided into 2 groups according to the presence (PMC group) or absence (NPMC group) of Modic changes within 1 year postoperative follow-up. Preoperative demographic characteristics and perioperative imaging parameters were recorded and compared between the 2 groups. Further multivariate logistic regression analyses were performed for identifying confounding and independent influencing factors. Finally, receiver operating characteristic (ROC) curve analysis was employed to identify the optimal cutoff value of disc removal for the prediction of PMC. Results: Fifty-two cases (31.1%) developed PMC. At 6 months postoperatively, the visual analogue scale (VAS) of the PMC group was significantly higher than that of the control group (p < .05). Logistic regression analysis showed that reduced preoperative intervertebral disc height (p = .003), large anterior-posterior diameter of the removed intervertebral disc (p = .018), and the intervertebral disc removed crossing the midline during surgery (p < .001), and the higher Pfirrmann grade (p < .001) were independent risk factors for the occurrence of PMC. Conclusions: Our study identified an independent association between the extent of intervertebral disc resection during PETD and the incidence of PMC. A prospective study is warranted to investigate the effect of sufficient decompression without aggressive disc resection on postoperative Modic changes.
SN - 2666-5484
ER -