SYSTEMATIC REVIEW article
Front. Surg.
Sec. Orthopedic Surgery
This article is part of the Research TopicClinical and Basic Research on Chronic Spinal Cord Injury Associated with Spinal DegenerationView all 18 articles
Association of Modic change with recurrence of lumbar disc herniation after percutaneous endoscopic lumbar discectomy: a meta-analysis
Provisionally accepted
- The Second People's Hospital of Yibin City, Yibin, China
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Purpose To identify the association between preoperative Modic changes and the recurrence of lumbar disc herniation (LDH) among patients receiving percutaneous endoscopic lumbar discectomy (PELD). Methods PubMed, Web of Science, EMbase and CNKI databases were searched from inception up to March 19, 2025. Early and late recurrence were defined as the recurrence occurring within six months and after 12 months after the surgery. Odds ratios (ORs) with 95% confidence intervals (CIs) were combined and subgroup analysis was performed by the recurrence type. Results Twenty-seven studies with 10116 patients were included and most studies were from China (25/27). The recurrence rates for patients without and with Modic changes were 7.44% and 16.41% (type I: 15.01%; type II/III: 18.14%) (P<0.001). The presence of Modic changes was associated with significantly increased risk of recurrence (OR=2.96, 95% CI: 2.29-3.82, P<0.001) and subgroup analysis by the recurrence period (early or late) manifested consistent findings. However, patients with Modic type II/III changes did not real a higher risk of recurrence than patients with Modic type I change did (OR=1.13, P=0.217). Conclusion Preoperative Modic change is associated with postoperative recurrence among LDH patients after PELD and the presence of Modic changes is related to significantly higher risk of early and late recurrence.
Keywords: Modic change, Lumbar disc herniation, Percutaneous endoscopic lumbar discectomy, Recurrence, Meta-analysis
Received: 28 Aug 2025; Accepted: 11 Nov 2025.
Copyright: © 2025 Li, Ren, Peng and Yuan. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Jiaqin Yuan, yjqttxs@163.com
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