许莫氏结节与腰椎间盘退变分型的相关性研究

The association of Schmorl's nodes with lumbar intervertebral discs degeneration type

目的研究许莫氏结节在腰椎MRI中的分布特点,及其与腰椎间盘退变类型的相关性。方法选取2016年9月1日～2016年12月1日在广州中医药大学第一附属医院行腰椎MRI检查的患者781例,记录其年龄、性别、结节发生部位、结节MRI信号类型及其邻近椎间盘退变类型等信息,并对其相关数据进行统计分析。结果在781例(男376例,女405例)患者中发现许莫氏结节患者93例(男性54例,女性39例)。许莫氏结节在男性中的发生率为14.4%,女性9.6%(P<0.05);许莫氏结节多发生于上终板(3.3%),下终板的发生率为2.4%(P<0.05);93例许莫氏结节患者共计465个腰椎间盘节段,退变255个,许莫氏结节在腰椎间盘退变中的发生率较高(47.8%),许莫氏结节MRI信号无异常改变组的相应椎间盘退变发生率低于脂肪沉积组及急性炎症水肿组(P<0.05);膨出127个,许莫氏结节在腰椎间盘膨出中的发生率较高(48%),双侧或单侧终板发生许莫氏结节在腰椎间盘膨出中的发生率之间无明显差异;许莫氏结节与腰椎间盘突出、脱出、HIZ无相关性(P>0.05);modic改变64个,许莫氏结节在腰椎modic改变中的发生率较高(73.4%)(P<0.05)。结论腰椎许莫氏结节的发生与腰椎间盘退变、膨出有明显关系,并与modic改变密切相关;许莫氏结节的MRI信号类型不同,相邻腰椎间盘退变的发生率也不同。

Objective The purpose of this study was to evaluate the distribution of Schmorl’snodes(SN)in MRI images of the lumbar spine and analyze the correlation between SN with degeneration type of lumbar intervertebral discs.Methods 781 patients examined by lumbar MRI scan were included in the study.The patients’ age,sex,location in different vertebra of the Schmorl’s nodes,the MRI signals’ type of Schmorl’s nodes,the degeneration type of lumbar intervertebral discs and the MRI data were all recorded and contrast analyzed.Results 93 Schmorl’s nodes patients(male:54,female:39)were detected in 781 participants(male:376,female:405).The incidence of Schmorl’s nodes in male was14.4% and female 9.6%(P<0.05).Most Schmorl’s nodes located at the superior endplates of vertebra(3.3%)and the inferior endplates of vertebra(2.4%)(P<0.05).93 patients had 465 intervertebral disc segments.255 segments of 465 disc segments were involved with lumbar intervertebral discs degeneration.The incidence of lumbar Schmorl’s nodes in disc degeneration was 47.8%.The incidence of normal signal’s SN in disc degeneration was lower than the other two(P<0.05).127 segments of 465 disc segments were involved with disc bulging.The incidence of lumbar Schmorl’s nodes in disc bulging was 48%(P<0.05).The incidence of disc bulging was no significant differences between groups with both sides Schmorl’s nodes and one side Schmorl’s nodes.Disc herniation,disc prolapsed and HIZ seemed not to be correlated to the incidence of lumbar Schmorl’s nodes(P>0.05).Modic changes were 64.The incidence of lumbar Schmorl’s nodes in Modic changes was 73.4%(P<0.05).Conclusion The Schmorl’s nodes had a obvious relationship with disc degeneration and disc bulging.Schmorl’s nodes are highly associated with Modic changes.The incidence of lumbar intervertebral disc degeneration is different in different types of SN’s MRI signals.