腰椎Modic Ⅰ改变危险因素研究  

Study on risk factors of lumbar Modic Ⅰ changes

作　　者：韩志巍 文娣娣 崔博 张劲松 李天云 赵向乾 HAN Zhiwei;WEN Didi;CUI Bo;ZHANG Jinsong;LI Tianyun;ZHAO Xiangqian(Department of Radiology,Xijing Hospital,the Air Force Military Medical University,Xi'an 71o032,China)

机构地区：[1]空军军医大学西京医院放射科,陕西西安710032

出　　处：《实用放射学杂志》2023年第1期104-107,共4页Journal of Practical Radiology

基　　金：陕西省自然科学基础研究计划项目(2020JQ一461)。

摘　　要：目的探讨与腰椎ModicⅠ(MCⅠ)改变发生的相关危险因素.方法回顾性选取经腰椎MRI检查诊断为MCⅠ改变患者47例,无腰椎Modic改变患者57例,并于MRI检查3 d内采集患者性别、年龄、初发年龄、体质量指数(BMI)、病程、习惯体位等一般资料,在MRI图像上评价退变最重的椎间盘、椎小关节以及多裂肌的退变等级,记录患者有无许莫氏结节、椎间盘纤维环高信号区(HIZ)以及腰背部筋膜水肿数目,并且测量最窄处椎管及硬膜囊面积、L4~L5椎间盘中心层面双侧多裂肌面积等.应用SPSS 25.0统计学软件先后进行单因素分析、二元Logistic回归分析,明确MCI危险因素.结果2组间患者年龄(t=2.391,P=0.019)、初发年龄(t=2.447,P=0.016)、习惯体位(Z=6.891,P=0.032)统计学差异显著;退变最重椎间盘2组间统计学差异显著(Z=-4.728,P<0.001),椎间盘膨/突出2组间统计学差异显著(Z=9.169,P=0.010);终板退变分级(Z=-0.607,P<0.001)、筋膜水肿个数(Z=-3.223,P=0.001)、肌肉退变(脂肪浸润)分级(Z=-3.729,P<0.001)、纤维环高信号区(HIZ)(x2=30.238,P<0.001)2组间统计学差异显著.经二元Logistic回归分析后习惯体位(坐)(B=2.686,P=0.005)、习惯体位(走)(B=3.017,P=0.021)、终板1级退变(B=3.977,P<0.001)、终板2级退变(B=2.529,P=0.040)、纤维环HIZ(B=2.120,P=0.007)等,是MCI发生的危险因素.结论持续坐或走、终板退变、纤维环HIZ是MCI发生的危险因素.Objective To explore the related risk factors of lumbar Modic Ⅰ(MCⅠ)change.Methods Forty-seven patients with MC Ⅰ change,and 57 patients without MC Ⅰ change diagnosed by lumbar MRI were retrospectively selected.The data of sex,age,initial age,body mass index(BMI),course of the disease,and habitual posture were collected within 3 days of MRI scanning,and the most severe degeneration of the intervertebral disc,facet joint and muscle was evaluated on MRI images.Record whether the patient had schmorl's nodes and intervertebral disc annulus fibrosus high intensive zone(HIZ),the numberof low back fascial edema.The narrowest area of the spinal canal and dural sac and the area of bilateral multi-issue muscle on the central plane of lumbar 4-5 intervertebral disc were measured.Univariate analysis and binary Logistic regression analysis were performed by SPSS 25.O statistical software.Results There were statistically significant differences between the two groups in age(t=2.391,P=0.019),age of onset(t=2.447,P=0.016),and customary position(Z=6.891,P=0.032).There were statistically significant differences between the two groups of the heaviest intervertebral disc degeneration(Z=-4.728,P<0.001),and there were statistically significant differences between the two groups of disc bulge and herniation(Z=9.169,P=0.010).There were statistically significant differences between the two groups in the grade of endplate degeneration(Z=-0.607,P<0.001),the number of fascia edema(Z=-3.223,P=0.001),the grade of muscle degeneration(fat infiltration)(Z=-3.729,P<0.001),and annulus fibrosus HIZ(x²=30.238,P<0.001).After binary Logistic regression analysis,the conventional posture(sitting)(B=2.686,P=0.005),the conventional posture(walking)(B=3.017,P=0.021),the grade 1 degeneration of endplate(B=3.977,P<0.001),the grade 2 degeneration of endplate(B=2.529,P=0.040),annulus fibrosus HIZ(B=2.120,P=0.007),etc.were risk factors for MCⅠ.Conclusion Persistent sitting or walking,endplate degeneration,and annulus fibrosus HIZ are risk factors for

关 键 词：腰椎 ModicⅠ改变 下腰痛 磁共振成像 

分 类 号：R681.57[医药卫生—骨科学] R445.2[医药卫生—外科学]