腰椎间盘退行性变与modic改变及椎旁肌肉脂肪含量的磁共振相关性分析

MR correlation analysis of lumbar intervertebral disc degeneration with Modic change and paravertebral muscle fat content

目的:腰椎间盘退行性变是造成腰痛的主要原因,本研究通过分析腰椎间盘退行性变与椎体终板及椎旁肌肉组织脂肪含量异常的相关性,评估腰椎间盘退行性变是否是一种脊柱整体性疾病的表现。方法:对1320名随机入选的腰痛患者进行Magnetic Resonance Imaging(MRI)检查,经Pfirrmann分级系统分析评估腰椎间盘退行性变,该分级系统可通过区别椎间盘髓核和纤维环、分析椎间盘信号强度与高度来评估椎间盘状态,并且经MRI测量Modic改变及椎旁肌肉脂肪含量。结果:L2~L5水平椎间盘的重度退行性变与2型Modic改变具有相关性(OR范围3.2~22.8,P≤0.05)。而且,各水平椎间盘的重度退行性变与椎旁肌肉脂肪含量增高具有相关性(OR范围3.3~16.1,P≤0.05)。结论:研究数据表明腰椎间盘退行性变与Modic改变和椎旁肌肉脂肪含量增高具有一致性,表现出整体的病理改变,这个发现可能有助于确定治疗和预防腰椎间盘退行性变的新目标。

Objective Lumbar intervertebral disc degeneration is the main cause of low back pain.This study assessed whether lumbar intervertebral disc degeneration is a manifestation of overall spinal disease by analyzing its correlation with abnormal changes of vertebral endplate and abnormal fat content of paravertebral muscle tissue.Methods 1320 randomly selected patients with low back pain were examined by magnetic Resonance imaging(MRI).The degeneration of lumbar intervertebral disc was evaluated by Pfirrmann grading system.The grading system can distinguish the nucleus pulposus and annulus fibrosus of intervertebral disc,analyze the signal intensity and height of intervertebral disc,and evaluate the state of intervertebral disc by MRI.Modic changes and paravertebral muscle fat content were measured.Results Severe degeneration of L2~L5 level intervertebral disc was correlated with type 2 Modic changes(OR range 3.2 to 22.8,P≤0.05).Moreover,there was a correlation between severe degeneration of intervertebral discs at all levels and increased fat content in paravertebral muscles(OR range 3.3 to 16.1,P≤0.05).Conclusion Research data show that lumbar intervertebral disc degeneration is consistent with Modic changes and increased paravertebral muscle fat content,showing overall pathological changes.This finding may help to identify new targets for the treatment and prevention of lumbar intervertebral disc degeneration.