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[1]張曉冬,王國柱,莊汝杰.腰椎Modic改變面積與腰痛程度的關(guān)系[J].中醫(yī)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改變面積與腰痛程度的關(guān)系()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第26卷
期數(shù):
2014年10期
頁碼:
16-19
欄目:
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:
張曉冬1; 王國柱1; 莊汝杰2
1.陜西中醫(yī)學(xué)院第二附屬醫(yī)院,陜西 咸陽 712000;
2.浙江省中醫(yī)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
關(guān)鍵詞:
腰痛 腰椎 Modic改變 磁共振成像
Keywords:
Low back pain;  Lumbar vertebrae;  Modic changes;  Magnetic resonance imaging
摘要:
目的:探討存在腰椎Modic改變的腰痛患者的腰椎Modic改變面積與腰痛程度的關(guān)系。方法:選取56例存在腰椎Modic改變的 腰痛患者,男26例,女30例。年齡29～80歲,中位數(shù)50.5歲。病程6～54個月,中位數(shù)26.5個月。所有患者均不合并其他可引起腰部 疼痛的疾病。對所有患者進(jìn)行腰椎MRI檢查,在正中矢狀位T2WI上測定Modic改變面積、腰椎曲度及Modic改變節(jié)段對應(yīng)椎間隙高 度,同時采用JOA腰痛疾患療效評定標(biāo)準(zhǔn)評定所有患者的腰部疼痛情況。分別按腰椎曲度、椎間隙高度及JOA評分對患者進(jìn)行分組 ,比較各組患者的Modic改變面積。結(jié)果:①腰椎曲度與Modic改變面積的關(guān)系。按照腰椎曲度將患者分為3組,A組(腰椎曲度 <0.9 cm)30例,B組(0.9 cm≤腰椎曲度<1.8 cm)18例,C組(1.8 cm≤腰椎曲度≤2.3 cm)8例。3組患者M(jìn)odic改變面積比較, 差異無統(tǒng)計學(xué)意義[(303.40±277.85)mm2,(259.42±69.16)mm2,(214.89±46.46) mm2,F=0.651,P=0.526]。②椎間隙高度與Modic改變面積的關(guān)系。按照Modic改變對應(yīng)椎間隙高度將患者分為3組,a 組(椎間隙高度<0.7 cm)21例,b組(0.7 cm≤椎間隙高度<1.4 cm)19例,c組(1.4 cm≤椎間隙高度≤2.3 cm)16例。3組患者 Modic改變面積比較,差異有統(tǒng)計學(xué)意義[(255.50±109.42)mm2,(128.08±19.37)mm2, (61.28±18.50)mm2,F=23.469,P=0.000]。a組Modic改變面積大于b、c組(P=0.000,P=0.000),b組大于c組 (P=0.048)。③JOA評分與Modic改變面積的關(guān)系。按照J(rèn)OA評分將患者分為3組,Ⅰ組(JOA評分≥16分)13例,Ⅱ組(10分≤JOA評分 ≤15分)21例,Ⅲ組(JOA評分<10分)22例。3組患者M(jìn)odic改變面積比較,差異有統(tǒng)計學(xué)意義[(114.40±43.90) mm2,(229.41±29.56)mm2,(477.04±168.21)mm2,F=51.846,P=0.000]。Ⅰ組 Modic改變面積小于Ⅱ、Ⅲ組(P=0.004,P=0.000),Ⅱ組小于Ⅲ組(P=0.000)。結(jié)論:存在腰椎Modic改變的腰痛患者,其腰痛程度與 腰椎Modic改變面積有關(guān),而后者又與對應(yīng)節(jié)段的椎間隙高度有關(guān)。
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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備注/Memo

備注/Memo:
基金項目:浙江省自然科學(xué)基金項目(Y2110747)
通訊作者:莊汝杰 E-mail:[email protected]
更新日期/Last Update: 2014-10-30