下腰痛患者Modic改变的临床分布及其分型的相关因素

The clinical distribution of Modic change and related factors of its classification in patients with lower back pain

目的探讨下腰痛患者Modic改变的临床分布及其分型的相关因素。方法收集103例下腰痛患者的性别、年龄、受累节段、相关节段的椎间盘退变和突出、腰椎曲度和终板凹角等数据,采用单因素分析和logistic回归分析Modic改变分型的相关因素。结果Modic改变的患者中Ⅰ型16例(15.5%),Ⅱ型83例(80.6%),Ⅲ型4例(3.9%)。共127个节段存在Modic改变:L1~2节段3个,L2~3节段8个,L3~4节段13个,L4~5节段38个,L5~S1节段65个。因Ⅲ型Modic改变的病例过少,各相关因素的分析中仅对Ⅰ型和Ⅱ型进行统计研究。单因素分析表明年龄、椎间盘退变和L4~5前凸角与Modic改变分型有关,logistic回归分析表明仅年龄与Modic改变分型有关。结论在下腰痛患者中Modic改变Ⅱ型最为常见,其次是Ⅰ型,Ⅲ型不常见;Modic改变主要发生在L4~5和L5~S1节段;年龄是Modic改变分型的影响因素。

Objective To investigate the clinical distribution of Modic changes( MC) and related factors of its classification in patients with lower back pain. Methods The clinical data of 103 patients were collected,including the gender,age,affected segment,the disc degeneration and protrusion,lumbar curvature degree and endplate concave angle of relataed spinal segement. The single factor analysis and logistic regression analysis were used to study the related factors of MC classification. Results Among the MC patients,16 patients( 15. 5%) were with type Ⅰ,83 patients( 80. 6%) with type Ⅱ,and 4 patients( 3. 9%) with type Ⅲ. A total of 127 segments were found with MC:L1 ~ 2( 3 disks),L2 ~ 3( 8 disks),L3 ~ 4( 13 disks),L4 ~ 5( 38 disks) and L5~ S1( 65 disks). Because the cases of typeⅢ MC were too few,only type Ⅰ,Ⅱ were performed with the statistical study in various related factors analysis. Single factor analysis showed that age,disc degeneration and L4 ~ 5 lordosis angle were related to MC classification,while logistic regression analysis showed that only age was related to MC classification. Conclusions In the patients with lower back pain,MC of type Ⅱ is most common,followed by type Ⅰ,type Ⅲ is not common,and MC are found mainly in L4 ~ 5,L5~ S1 segements;age is the related factor of MC classification.