下腰痛患者椎体Modic改变累及范围与椎间盘退变的相关性

Correlation Between Modic Change Range of Vertebral Body and Intervertebral Disc Degeneration in Patients with Low Back Pain

目的:基于腰椎MRI检查,分析椎体终板中Modic改变的累及范围与椎间盘退变的严重程度的相关性。方法:回顾性分析2019年1月-2021年1月莒南县人民医院收治的具有腰椎Modic改变的慢性病持续性下腰痛患者的腰椎MRI检查资料,选取具有腰椎Modic改变的患者192例,将纳入患者根据Modic改变累及范围分为A型(累及终板≤1/3)、B型(累及终板>1/3,≤2/3)、C型(累及终板>2/3),比较三组椎间盘退变Pfirrmann分级,分析椎体Modic改变的累及范围与椎间盘退变Pfirrmann分级的关系。结果:192例患者中,Modic改变共278处椎间盘邻近终板Modic改变,Modic改变更常见于L_(4~5)、L_(5)~S_(1)椎间盘邻近终板70%(n=194),Modic改变在不同椎间盘退变等级间发生情况比较,差异有统计学意义(P<0.05),Modic改变累及范围类型与椎间盘退变等级呈正相关,差异有统计学意义(P<0.05)。结论:腰椎Modic改变累及范围类型与椎间盘退变严重程度具有相关性。

Objective:To analyze the correlation between the range of Modic changes in the vertebral endplates and the severity of intervertebral disc degeneration based on lumbar MRI examination.Methods:The lumbar MRI data of patients with chronic persistent low back pain and Modic changes who were admitted to People's Hospital of Junan County from January 2019 to January 2021 were retrospectively analyzed.One hundred and ninety-two patients with Modic changes were selected.According to the range of Modic changes,the included patients were divided into type A(involving≤1/3 of the endplate),type B(involving>1/3,≤2/3 of the endplate)and type C(involving>2/3 of the endplate).The Pfirrmann grade of intervertebral disc degeneration in three groups was compared.The correlation between the range of Modic changes and the Pfirrmann grade of intervertebral disc degeneration was analyzed.Results:Among the 192 patients,Modic change was involved in 278 endplates adjacent to intervertebral disc,Modic changes were more common in endplates adjacent to L_(4~5) and L_(5)~S_(1) discs,accounting for 70%(n=194).The difference was statistically significant in the Modic changes at different grades of intervertebral disc degeneration(P<0.05),and the range of Modic changes was positively correlated with the grade of intervertebral disc degeneration(P<0.05).Conclusion:The range of Modic changes in the lumbar spine is correlated with the severity of intervertebral disc degeneration.