[1]张晓冬,王国柱,庄汝杰.腰椎Modic改变面积与腰痛程度的关系[J].中医正骨,2014,26(10):16-19.
　Zhang Xiaodong*,Wang Guozhu,Zhuang Rujie.*.Clinical study on the relationship between lumbar modic changes area and low back pain degree[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2014,26(10):16-19.
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腰椎Modic改变面积与腰痛程度的关系()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第26卷
期数:
2014年10期
页码:
16-19
栏目:
脊柱退行性疾患
出版日期:
2014-10-30

文章信息/Info

Title:
Clinical study on the relationship between lumbar modic changes area and low back pain degree
作者:
张晓冬1; 王国柱1; 庄汝杰2
1.陕西中医学院第二附属医院,陕西 咸阳 712000;
2.浙江省中医院,浙江 杭州 310006
Author(s):
Zhang Xiaodong*;  Wang Guozhu; Zhuang Rujie.*
The Second Affiliated Hospital of Shanxi College of Traditional Chinese Medicine,Xianyang 712000,Shanxi,China
关键词:
腰痛 腰椎 Modic改变 磁共振成像
Keywords:
Low back pain;  Lumbar vertebrae;  Modic changes;  Magnetic resonance imaging
摘要:
目的:探讨存在腰椎Modic改变的腰痛患者的腰椎Modic改变面积与腰痛程度的关系。方法:选取56例存在腰椎Modic改变的 腰痛患者,男26例,女30例。年龄29～80岁,中位数50.5岁。病程6～54个月,中位数26.5个月。所有患者均不合并其他可引起腰部 疼痛的疾病。对所有患者进行腰椎MRI检查,在正中矢状位T2WI上测定Modic改变面积、腰椎曲度及Modic改变节段对应椎间隙高 度,同时采用JOA腰痛疾患疗效评定标准评定所有患者的腰部疼痛情况。分别按腰椎曲度、椎间隙高度及JOA评分对患者进行分组 ,比较各组患者的Modic改变面积。结果:①腰椎曲度与Modic改变面积的关系。按照腰椎曲度将患者分为3组,A组(腰椎曲度 <0.9 cm)30例,B组(0.9 cm≤腰椎曲度<1.8 cm)18例,C组(1.8 cm≤腰椎曲度≤2.3 cm)8例。3组患者Modic改变面积比较, 差异无统计学意义[(303.40±277.85)mm2,(259.42±69.16)mm2,(214.89±46.46) mm2,F=0.651,P=0.526]。②椎间隙高度与Modic改变面积的关系。按照Modic改变对应椎间隙高度将患者分为3组,a 组(椎间隙高度<0.7 cm)21例,b组(0.7 cm≤椎间隙高度<1.4 cm)19例,c组(1.4 cm≤椎间隙高度≤2.3 cm)16例。3组患者 Modic改变面积比较,差异有统计学意义[(255.50±109.42)mm2,(128.08±19.37)mm2, (61.28±18.50)mm2,F=23.469,P=0.000]。a组Modic改变面积大于b、c组(P=0.000,P=0.000),b组大于c组 (P=0.048)。③JOA评分与Modic改变面积的关系。按照JOA评分将患者分为3组,Ⅰ组(JOA评分≥16分)13例,Ⅱ组(10分≤JOA评分 ≤15分)21例,Ⅲ组(JOA评分<10分)22例。3组患者Modic改变面积比较,差异有统计学意义[(114.40±43.90) mm2,(229.41±29.56)mm2,(477.04±168.21)mm2,F=51.846,P=0.000]。Ⅰ组 Modic改变面积小于Ⅱ、Ⅲ组(P=0.004,P=0.000),Ⅱ组小于Ⅲ组(P=0.000)。结论:存在腰椎Modic改变的腰痛患者,其腰痛程度与 腰椎Modic改变面积有关,而后者又与对应节段的椎间隙高度有关。
Abstract:
Objective:To explore the relationship between lumbar modic changes area and low back pain degree in the patients with low back pain and lumbar modic changes.Methods:Fifty-six patients(26 males and 30 females) with low back pain and lumbar modic changes were selected,which median age was 50.5 years(ranged from 29 to 80 years)and median course of disease was 26.5 months(ranged from 6 to 54 months).Other diseases which could cause low back pain were excluded in all of the patients.The lumbar MR examination was performed upon all the patients.The modic changes area,lumbar curvature and the height of intervertebral space at the lumbar segment with modic changes were measured on the median sagittal T2-weighted image.Meanwhile,the severity of low back pain of all patients were evaluated according to JOA scores for low back pain.The patients were grouped according to lumbar curvature,intervertebral space height and JOA scores,respectively,then the modic changes areas were compared between the groups.Results:The patients were divided into group A(30),B(18)and C(8) according to the lumbar curvature(<0.9 cm,0.9 to 1.8 cm,and 1.8 to 2.3 cm).There was no statistical difference in modic changes area between the 3 groups(303.40+/-277.85,259.42+/-69.16,214.89+/-46.46 mm (2),F=0.651,P=0.526).The patients were divided into group a(21),b(19)and c(16)according to the height of intervertebral space(<0.7 cm,0.7 to 1.4 cm,and 1.4 to 2.3 cm),There was statistical difference in modic changes area between the 3 groups(255.50+/-109.42,128.08+/-19.37,61.28+/-18.50 mm(2),F=23.469,P=0.000).The modic changes area was greater in group a compared with group b and group c(P=0.000,P=0.000),and was greater in group b compared with group c(P=0.048).The patients were divided into groupⅠ(13),Ⅱ(21)andⅢ(22)according to JOA scores(≥16 points,10 to 15 points,and <10 points).There was statistical difference in modic changes area between the 3 groups(114.40+/-43.90,229.41+/-29.56,477.04+/- 168.21 mm(2),F=51.846,P=0.000).The modic changes area was less in groupⅠcompared with groupⅡand groupⅢ (P=0.004,P=0.000)and was less in groupⅡcompared with group Ⅲ(P=0.000).Conclusion:For patients with low back pain and lumbar modic changes,the low back pain degree is associated with lumbar modic changes area,while the latter is also associated with the height of intervertebral space.

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备注/Memo

备注/Memo:
基金项目:浙江省自然科学基金项目(Y2110747)
通讯作者:庄汝杰 E-mail:rujiezhuang@163.com
更新日期/Last Update: 2014-10-30