Modic changes (MCs) associated with endplate sclerosis can prevent cage subsidence in oblique lumbar interbody fusion (OLIF) stand-alone.

Abstract Objective 1) To investigate the association between MCs and endplate sclerosis; 2) To investigate the effect of MCs and endplate sclerosis on cage subsidence in OLIF stand-alone. Methods We included 78 inpatients who underwent OLIF stand-alone from August 2015 to August 2017. All patients underwent CT and MRI. The presence and the types of MCs were assessed. Endplate sclerosis was evaluated from sagittal reconstructed CT images. Cage subsidence was evaluated at the 1, 3, 6, and 12-month follow-up. Results Of 78 patients, 92 discs underwent OLIF without posterior instrumentation, 32/92(34.8%) had MCs; Type I, II, and III MCs were seen in 10 (10.9%), 19 (20.7%), and 3 (3.2%) endplates, respectively. Among 32 endplates with MCs, 10 (31.3%) showed evidence of sclerosis on CT images including: 2/10 endplates (20%) with Type I MCs, 5/19 (26.3%) with Type II, and 3/3 (100%) with Type III. Among 60 endplates without MCs, 5 (8.3%) showed evidence of sclerosis. Cage subsidence rate in no-MCs group was higher than the MCs group (P Conclusion MCs associated with endplate sclerosis can prevent cage subsidence in OLIF stand-alone.