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Surgery increased the odds of vertebral endplate signal changes for patients with sciatica
Researchers found surgery for sciatica increased vertebral endplate signal changes after 1 year and disabling back pain presented equally in sciatica patients with and without vertebral endplate signal changes.
“In contrast with the intuitive feeling of spine specialists, those with and those without vertebral endplate signal changes reported disabling back pain in nearly the same proportion,” Abdelilah el Barzouhi, MD, MSc, and colleagues wrote in the abstract. “Therefore, vertebral endplate signal change does not seem to be responsible for disabling back pain in patients with sciatica.”
Investigators compared 129 patients who underwent early surgery and 134 patients who underwent conservative care for sciatica that lasted between 6 weeks and 12 weeks. The patients’ vertebral endplate signal changes (VESC) were measured at baseline and 1-year follow-up. Overall, 39% of patients showed disabling back pain at baseline, of which 40% of patients with VESC had disabling back pain and 38% of patients with no VESC had disabling back pain. Patients in the early surgery group showed increased type 1 VESC from 1% at baseline to 35% at 1-year follow-up. Patients who received conservative care had increased type 1 VESC of 3% at baseline to 11% at 1-year. Type 2 VESC decreased from 40% to 29% from baseline to 1-year follow-up in the early surgery group, but there was no change in type 2 VESC from baseline to 1-year in the conservative group.
The researchers found disabling back pain at 1 year in 12% of patients with no VESC, 16% of patients with type 1 VESC, 11% of patients with type 2 VESC and 3% of patients with type 1 and 2 VESC.
Disclosure: Barzouhi has no relevant financial disclosures. The study was supported by a grant from the Netherlands Organisation for Health Research and Development and the Hoelen Foundation.