需手术干预的脊髓型颈椎病患者颈椎Modic改变及相关临床因素分析  

Modic changes in patients with cervical spondylitic myelopathy requiring surgical intervention and related clinical factors

作　　者：周浩[1] 孙鹏[1] 周炜[1] 凡进[1] 王维东[1] 万博文 殷国勇[1] 

机构地区：[1]南京医科大学第一附属医院骨科,江苏南京210029

出　　处：《南京医科大学学报（自然科学版）》2014年第7期973-976,共4页Journal of Nanjing Medical University(Natural Sciences)

基　　金：国家自然科学基金资助(81000754)

摘　　要：目的：探讨需手术干预的脊髓型颈椎病（CSM）患者颈椎MRI图像上Modic改变发生率及临床相关因素。方法：2009年5月-2013年3月在本院住院手术的133例CSM患者,收集术前MRI及颈椎过伸过屈位片,评判Modic改变的发生情况,并测算椎管有效容积（space available for the cord,SAC）,测量颈椎动力位片上颈椎总活动度（total angle of motion,TAM）和病变节段活动度（segmental angle of motion,SAM）。用秩和检验做临床相关因素统计学分析。结果：在需要手术干预的脊髓型颈椎病患者中,Modic改变发生率为51.1%。高龄（〉60岁）,后伸活动度增加,椎管狭窄较严重的患者,Modic改变的发生率较高。病史长短和性别与Modic改变无相关性。结论：高龄、椎间盘突出导致的较严重椎管狭窄以及颈椎局部过伸位活动度增加,和颈椎Modic改变的发生密切相关。Objective：To explore the incidence of cervical Modic changes and related clinical factors of cervical spondylitic myelopathy（CSM） of patients requiring surgical intervention by MRI image. Methods：A total of 133 patients with CSM were collected from our hospital between May,2009 and March,2010. Flexion extension radiographs and preoperative MRI were collected.We evaluated cervical Modic changes and measured space available for the cord（SAC）. Then,we measured total angle of motion（TAM） and segmental angle of motion（SAM） on cervical flexion-extension radiographs. Rank sum test was performed to analyze the clinical relevant factors. Results：Modic change incidence was 51.1% from patients with cervical myelopathy requiring surgical intervention. In patients who were over 60-year-old and with increased extension activity and more severe spinal stenosis, the incidence of Modic change was higher. The length of medical history and sex were not correlated to Modic change. Conclusion：Severe spinal stenosis and the increment of SAM on partial cervical flexion-extension radiograph due to aging and protrusion of intervertebral disc were intensively correlated with cervical Modic changes.

关 键 词：脊髓型脊椎病 MODIC改变 活动度 颈椎间盘突出 

分 类 号：R681.5[医药卫生—骨科学]