MRI在年轻人腰骶移行椎伴椎间盘退变中的评估价值

Evaluation of MRI in lumbosacral transitional vertebrae with intervertebral disc degeneration in young patients

目的:探讨年轻人腰骶移行椎(LSTV)与椎间盘退变MRI征象之间的关系。方法:回顾性分析病例组74例LSTV(男性45例,女性29例,平均年龄28±5岁)和对照组75例非LSTV(男性34例,女性41例,平均年龄28±4岁)均伴有下腰痛患者的所有资料。观察最下两个腰椎间盘MR征象特点,记录Pfirrmann分级、Modic改变(MC)、椎间盘局限性高信号区(HIZ)和椎间盘突出(LDH),并与对照组作比较。结果:LSTV组移行椎间盘退变(Pfirrmann 3-5级32.4%,HIZ6.8%,LDH14.9%),比对照组L5-S1椎间盘退变(Pfirrmann 3-5级49.3%,HIZ18.7%,LDH73.3%)更轻,差异有统计学意义(P<0.05)。而LSTV组移行椎间盘退变(MC8.1%)与对照组L5-S1(MC6.7%)比较,差异无统计学意义(P=0.737)。LSTV组上位椎间盘退变(Pfirrmann 3-5级52.7%,MC28.4%,LDH82.1%),比对照组L4-5椎间盘退变(Pfirrmann 3-5级29.3%,MC1.3%,LDH48.0%)更重,差异有统计学意义(P<0.05)。而LSTV组上位椎间盘退变(HIZ20.3%)与对照组L5-S1(HIZ16.0%)比较,差异无统计学意义(P=0.499)。此外,LSTV组上位椎间盘退变(Pfirrmann 3-5级,HIZ,LDH)与对照组L5-S1比较,差异无统计学意义(P=0.681,P=0.805,P=0.260)。而LSTV组上位椎间盘退变(MC)比对照组L5-S1发生率更高,差异有统计学意义(P<0.05)。结论:年轻人LSTV容易引起上位椎间盘提早退变,MRI可以准确评估椎间盘退变情况。

Objective:To investigate the relationship between lumbosacral transitional vertebra(LSTV)and MRI findings of intervertebral disc degeneration in young patients.Methods:All data of 74 patients with LSTV(45 males,29 females,mean age 28±5 years)in the case group and 75 patients without LSTV(34 males,41 females,mean age 28±4 years)in the control group were retrospectively analyzed.Pfirrmann grade,Modic change(MC),high-intensity zone(HIZ)and disc herniation(LDH)were recorded and compared with the control group.Results:Transitional disc degeneration(Pfirrmann 3-5 grade 32.4%,HIZ6.8%,LDH14.9%)in the LSTV group was less severe than L5-S1 in the control group(Pfirrmann 3-5 grade 49.3%,HIZ18.7%,LDH73.3%),and the difference was statistically significant(P<0.05).However,there was no significant difference between transitional disc degeneration(MC8.1%)in the LSTV group and L5-S1(MC6.7%)in the control group(P=0.737).The upper disc degeneration in the LSTV group(Pfirrmann 3-5 grade 52.7%,MC28.4%,LDH82.1%)was more severe than L4-5 in the control group(Pfirrmann 3-5 grade 29.3%,MC1.3%,LDH48.0%),and the difference was statistically significant(P<0.05).There was no significant difference between the upper disc degeneration in the LSTV group(HIZ20.3%)and L5-S1 in the control group(HIZ16.0%)(P=0.499).In addition,there was no statistically significant difference between the upper disc degeneration(Pfirrmann3-5,HIZ,LDH)in the LSTV group and L5-S1 in the control group(P=0.681,P=0.805,P=0.260).The incidence of upper disc degeneration(MC)in the LSTV group was higher than L5-S1 in the control group,and the difference was statistically significant(P<0.05).Conclusion:LSTV in young patients is prone to early degeneration of upper intervertebral discs,and MRI can accurately evaluate the degeneration of intervertebral discs.