腰椎终板Modic改变与腰椎间盘突出的相关性研究
Relationship between modic change of lumbar endplate and lumbar disc herniation
贺宪 1梁安靖 1彭焰 1张新亮 1张良明 1黄东生1
作者信息
- 1. 中山大学孙逸仙纪念医院脊柱外科,广州510120
- 折叠
摘要
[目的]探讨腰椎终板Modic改变与腰椎间盘突出的相关性及其意义.[方法]对628例患者(年龄14～85岁,平均50岁；男326例,女302例)腰椎MRI上L3、4～L5S1节段的Modic改变和腰椎间盘突出程度进行评估,统计两者的相关性.将单节段中、重度腰椎间盘突出者分为A组(仅该节段有Modic改变)和B组(任一节段均无Modic改变).统计两组下腰痛的发生率并采用疼痛视觉模拟评分(visual analogue scale,VAS)和Oswestry功能障碍指数评分(oswestry disability index,ODI)来评估腰痛程度.[结果]在1844个腰椎间盘中,椎间盘无突出组、轻度突出组、中度突出组和重度突出组Modic改变的发生率分别为6.83％、23.66％、42.72％和50.79％,差异有统计学意义(P＜0.01),Spearman相关检验表明Modic改变和腰椎间盘突出程度呈正相关(r=0.344,P＜0.01).A、B组下腰痛的发生率分别为59.32％和37.97％,差异有统计学意义(P＜0.01),但腰痛VAS评分和ODI评分差异无统计学意义(P＞0.05).[结论]腰椎终板Modic改变的发生与腰椎间盘突出程度呈正相关,当腰椎间盘突出合并Modic 改变特别是Ⅰ型改变时,下腰痛的发生率增加.
Abstract
[Objective] To explore the relationship between Modic change of lumbar endplate and lumbar disc herniation ( LDH) and the clinical value. [ Methods] The lumbar MR1 films were reviewed at L3. 4, L4.5 and L5S1 levels in 628 patients (326 men and 302 women) between 14 and 85 years of age. Modic change and the degree of LDH were evaluated. The relationship between them was analyzed Those patients with moderate or severe LDH only in one level were divided into group A (Modic change only in this level) and group B (no Modic change in any level) . The incidence and the severity of low back pain (LBP) between two groups were compared. Pain visual analogue scale (VAS) and Osawestry disability index (OD1) were used to evaluate the severity of LBP. [ Results] In 1 844 discs, the incidence of Modic change in non - LDH group, mild LDH group, middle LDH group and severe LDH group were6.83% , 23.66% , 42. 72% and50.79% respectively , with statistically significant difference (P <0. 01) . Spearman correlation test showed that Modic change was related to degree of LDH ( r = 0. 344, P<0. 01) . The incidence of LBP in groups A and B were 59. 32% and 37.97% , respectively, with statistically significant difference (P < 0.01) . But neither VAS score nor ODI score between the two groups had statistically significant difference (P>0.05) . [Conclusion] Modic change of lumbar endplate is positively related to LDH. LDH combined with Modic change, especially type 1 change, will increase the incidence of LBP.
关键词
Modic改变/腰椎间盘突出/下腰痛Key words
Modic change/lumbar disc hemiation/low back pain引用本文复制引用
基金项目
中山大学临床医学研究“5010”计划项目(2007020)
广东省自然科学基金(06104608)
出版年
2012
NETL
NSTL
维普
万方数据