Placebo-Controlled Trial of Oral Vitamin D and Alendronate Efficacy for Pain and Modic Changes in Lumbar Fusion Surgery

 Modic changes are alterations in the Spine endplates and subchondral bone signal absorption, which can be seen by MRI. Today, no studies have investigated the effect of vitamin D and alendronate as oral drugs on the reduction and modification of Modic changes after degenerative spine fusion surgery. Aim the study was to Evaluation of the efficacy of oral vitamin D and alendronate administration in patients with low back pain and Modic changes which undergoing lumbar fusion surgery.

81 middle age women with normal range of serum Vitamin D had enrolled in three groups who underwent lumbar fusion surgery according to neurosurgical criteria.   Group 1 (n = 27) received additional oral alendronate, Group 2 (n=27) received oral vitamin D for six months postoperatively, and whereas group 3 (n = 27) received no drug (except simple analgesics and antibiotics).patients follow with visual analog scale (VAS) and oswestry disability index (ODI), also MRI has done before and six month after surgery.

There was no significant difference in VAS and ODI between the three groups (P-value = 0.416, P-value = 0.601, respectively) but the mean VAS and ODI in all three groups decreased over six months, which was statistically significant (P-value < 0.001). MODIC change in all three groups changed significantly over 6 months (P-value < 0.01,). In the Vitamin D and Alendronate groups, MODIC 3 increased significantly, but MODIC 2 and MODIC 1 decreased significantly in the Vitamin D and No medication groups, respectively.

it is supposed to oral vitamin D administration has an acceptable effects not only on clinical outcome after lumbar spinal fusion surgery because of degenerative surgery, but also has a good effect on vertebral endplate modic change compared oral bisphosphonate.