腰椎前部结构MR退变征象与慢性下腰痛的关系

Relationship between MR findings of anterior lumbar elements and chronic low back pain

目的探讨腰椎前部结构MR退变征象与慢性下腰痛的关系。方法本研究回顾性分析2011年8月1日-2012年1月15日于我院就诊、并行腰椎MRI的患者,进行问卷调查,最终回收有效问卷386份,于其中选取慢性下腰痛者139例,其中68例为有神经根压迫组A,71例为无神经根压迫组B。选取本院无下腰痛且无神经根压迫的62名职工作为正常对照组C。观察下列MRI征象：平均间盘退变分级（ADD）、间盘后方高信号区（HIZ）、许莫氏结节、Modic I型改变。采用统计学方法分析MRI征象在不同组的分布特征。结果慢性下腰痛有神经根压迫组A、慢性下腰痛无神经根压迫组B、对照组C的MRI征象分布分别为：ADD（P50,2.20/P50,2.00/P50,1.40）、HIZ发生率（52.9%,39.4%,25.8%）、Modic I型改变发生率（22.1%,22.5%,4.8%）、许莫结节发生率（17.6%,18.3%,14.5%）。其中,ADD、Modic I型改变发生率在A、B组间无统计学差异,但较C组高,差异有统计学意义;许莫结节发生率在三组间无统计学差异。HIZ发生率在A、B组间及B、C组间无统计学差异,但在A、C组间有统计学差异。结论 ADD、Modic I型改变可能与慢性下腰痛有关。

Objective To investigate the relationship between the MR findings of anterior lumbar elements and chronic low back pain（CLBP）.Methods Of 521 questionnaires sent to patients who underwent lumbar MRI from August 12011 to January 152012 for low back pain,386 were useful.139 of these 386 patients with CLBP were enrolled and divided into a group of 68 patients with nerve root compression and a group of 71 patients without nerve root compression.62 hospital staff without low back pain and nerve root compression was recruited as control.The MRI findings including average disk degeneration（ADD） scores,high-intensity zones（HIZ）,Schmorl＇s nodes,and Modic I change were analyzed.Results The ADD scores and the incidence of Modic I change in the patients with（2.20,22.1%） and without（2.00,22.5%） nerve root compression were similar（P〉0.05） and significantly（P〈0.01） higher than that of the control group（1.40,4.8%）.There was no significant difference（P〉0.05） in the incidences of Schmorl＇s nodes among the three groups（17.6%,18.3%,14.5%）.The incidence of HIZ was significantly（P〈0.01） higher in patients with nerve root compression（52.9%） than that of control（25.8%） and not significantly different（P〉0.05） from that of patients without nerve root compression（39.4%）.Conclusion ADD scores and Modic I changes are associated with severity of CLBP.