Modic改变在腰腿痛患者中的分布特点及分析

Distribution of Modic changes of lumbar endplate in patients suffering from low back pain or radiculopathy and its

关键词:  腰椎  椎间盘  腰腿痛  Modic改变  磁共振成像

Key words:  lumbar vertebrae  intervertebral disc  low back pain  Modic changes  magnetic resonance imaging

摘要:

[目的]探讨腰椎终板Modic改变在腰腿痛病例中的分布特点及发生Modic改变的相关因素。[方法]选择2009年3月-2010年3月间因腰痛和/或坐骨神经痛行腰椎MR检查患者1040例，根据患者MR结果对其进行分类，分析其Modic改变的发生率以及分布特点，并研究其与性别、年龄及体重的关系。[结果]1040例5200个腰椎椎间盘中，368例(35.4％)患者的448个 (8.6％) 椎间盘邻近终板发生Modic改变，其中I型58例(5.6％)59个椎间盘(1.1％)，Ⅱ型307例(29.5％) 386个椎间盘(7.4％)，III型3例(0.3％)3个椎间盘(0.06％)。男性30.5％(168/550)发生Modic改变，女性为40.8％(200/490)，P<0.05。40岁以后各组Modic改变的发生率与39岁前的两组比较,差异有显著性意义（P<0.05）。在正常组与肥胖组之间差异有显著性意义（P<0.05），超重组与肥胖组之间差异也有显著性意义（P<0.05）。[结论]腰椎终板Modic改变在腰腿痛患者中的发生率较高；其中Ⅱ型居多；40岁以后多见；好发于L5-S1、L4-5这两个节段；女性发生率高于男性；Modic改变在肥胖人群中发生率高于正常体重和超重人群。

Abstract:

[Objectives]To evaluate the distribution of Modic changes of lumbar endplate in patients suffering from low back pain or radiculopathy and its related factors.[Methods]1040 patients suffering from low back pain or sciatica were examined by lumbar MRI scan from March 2009 to March 2010. According to the criteria of Modic changes, the features of distribution of Modic changes of lumbar endplate on segment, sex, age, and body mass index were analyzed retrospectively. [Results] Among 5200 intervertebral disc of the1040 patients, 368 (35.4％) cases and 448 (8.6％) intervertebral discs were involved with Modic changes. Among them, 58 (5.6％) cases and 59 (1.1％) discs were type I; 307(29.5％) cases and 386 (7.4％) discs were type II; 3 (0.3%) cases and 3 (0.06%) discs were type III. Female cases verse 29.5％(168/550) male cases in Modic change which means Modic changes distributed more often in female than in male (P<0.05). Modic changes in incidence after the age of 40 in each group and the difference between two groups before the 39-year-old was significant (P<0.05). There was significant difference between the normal group and obesity group (P<0.05). There was significant differences between over-weight group and obesity group (P<0.05). [Conclusion]Modic change of lumbar endplate was more often seen in patients suffering low back pain or radiculopathy. The changes of lumbar endplate mainly occurred in L5-S1 and L4-5 segment, and type II was the most, mainly happened in female and over 40 years old. Modic changes distributed more often in obesity group.