腰椎退变性滑脱与终板Modic改变的相关性研究  

Correlation between lumbar degenerative spondylolisthesis and endplate Modic changes

作　　者：吕晓艳[1] 石媛媛[1] 关春爽[1] 李莉[1] 秦宝琦[1] 蔡玉[1] 李学军[1] 

机构地区：[1]北京丰台医院放射科,北京市100070

出　　处：《中国脊柱脊髓杂志》2015年第5期400-404,共5页Chinese Journal of Spine and Spinal Cord

摘　　要：目的 :观察腰椎退变性滑脱患者腰椎终板的Modic改变情况,分析退变性滑脱与终板Modic改变之间的关系。方法:回顾性分析108例腰椎退变性滑脱症患者的MRI资料,观察腰椎滑脱节段与非滑脱节段终板Modic改变各型的发生率及分布情况,分析终板Modic改变与腰椎滑脱的相关性。结果:108例腰椎退变性滑脱患者共540个椎体中,Ⅰ度滑脱149个,Ⅱ度滑脱17个;L1椎体滑脱10个,L2椎体26个,L3椎体41个,L4椎体46个,L5椎体43个。108例腰椎退变性滑脱患者共计1080个腰椎终板,351个终板存在Modic改变,其中ModicⅠ型172个(15.93%),Ⅱ型144个(13.33%),Ⅲ型3个(0.28%),混合型32个(2.96%);L1/2节段34个(3.15%),L2/3节段61个(5.65%),L3/4节段65个(6.02%),L4/5节段77个(7.13%),L5/S1节段114个(10.56%)。腰椎滑脱节段终板的Modic改变发生率为75.30%,非滑脱节段终板的Modic改变发生率为13.50%,差异有统计学意义(P<0.05)。Spearman相关检验表明Modic改变和腰椎滑脱程度呈正相关(r=0.613,P<0.05)。结论 :腰椎退变性滑脱患者滑脱节段终板的Modic改变多见,各型中以Ⅰ型多发,Modic改变的发生与滑脱程度呈正相关。Objectives：To investigate the distribution characteristics of endplate Modic changes in patients with lumbar degenerative spondylolisthesis,and to analyze the correlation between degenerative spondylolisthesis and endplate Modie changes.Methods：The MRI images of 108 patients with lumbar degenerative spondylolisthesis were reviewed retrospectively.The parameters included the incidence and distribution of various types of endplate Modic changes in the spondylolisthesis segments and the other segments,and the correlation between endplate Modic changes and lumbar degenerative spondylolisthesis were analyzed.Results：Among 540 vertebral bodys of 108 patients with lumbar degenerative spondylolisthesis,149 were Grade Ⅰ spondylolisthesis,17 were Grade Ⅱ spondylolisthesis; the lesions involved L1 in 10,L2 in 26,L3 in 41,L4 in 46,L5 in 43.Among 1080 endplates of 108 patients with lumbar degenerative spondylolisthesis,351 endplates were involved in Modic changes,among these,172（15.93％） endplates were classified as type Ⅰ,144（13.33％） endplates were classified as type Ⅱ,3（0.28％） endplates were classified as type Ⅲ,and 32 （2.96％） endplate were classified as mixed type; the lesions involved L1/2 segment in 34 （3.15％）,L2/3 segment in 61 （5.65％）,L3/4 segment in 65 （6.02％）,L4/5 segment in 77 （7.13％）,L5/S1 segment in 114 （10.56％）.The incidence of Modie changes in the spondylolisthesis segments and non-slippage segements was 75.30％ and 13.50％ respectively,which showed significant difference（r=0.613,P＜0.05）.Conclusions：Endplate Modic changes in patients with lumbar degenerative spondylolisthesis appear more frequently in the dislocated vertebral body,Modic type Ⅰ is most common.Modic change of lumbar endplate is positively related to the degree of lumbar degenerative spondylolisthesis.

关 键 词：腰椎 退变性滑脱 MODIC改变 MRI 相关性 

分 类 号：R681.5[医药卫生—骨科学] R445.2[医药卫生—外科学]