腰椎间盘突出症初次手术患者中Modic改变的分布及其临床意义  

The Distribution of Modic Changes and Their Clinical Implications in Patients Undergoing First-time Surgery for Lumbar Disc Herniation

作　　者：桑树行 葛祥 于振 张栋 Sang Shuhang;Ge Xiang;Yu Zhen;Zhang Dong(Department of Spinal Surgery,Suzhou Clinical College of Bengbu Medical University and Suzhou Municipal Hospital of Anhui Province,Suzhou 234000,China)

机构地区：[1]蚌埠医科大学宿州临床学院暨安徽省宿州市立医院脊柱外科,安徽宿州234000

出　　处：《实用骨科杂志》2025年第2期138-141,151,共5页Journal of Practical Orthopaedics

基　　金：青年科学基金项目(2023xkj074)。

摘　　要：目的探讨腰椎间盘突出症初次手术患者中Modic改变(Modic changes,MC)的分布特征,分析其与年龄、性别、病变节段及椎间盘退行性改变的关系。方法分析2018年6月至2022年6月蚌埠医科大学宿州临床学院暨安徽省宿州市立医院初次接受手术治疗的551例(2755个椎体节段)腰椎间盘突出症患者资料,其中男234例,女317例;年龄15~87岁,平均(56.92±14.08)岁。记录患者年龄、性别、病变节段、椎间盘退行性改变程度及MC的类型和其分布节段情况。描述MC的分布特点并采用统计学方法分析其与腰椎退变的相关性。结果在551例患者2755个椎体节段中,MC的阳性率为12.6%。MC主要分布于L4~5和L5S1节段,占MC总数的83.5%。ModicⅡ型为最常见类型,占MC总数的89.6%。MC的发生率随年龄增长而增加(P<0.05),女性患者的MC发生率略高于男性,但差异无统计学意义(P>0.05)。MC的发生与椎间盘退行性改变程度呈正相关(P<0.05)。结论在腰椎间盘突出症初次手术患者中,MC主要分布于下腰椎节段,其中MCⅡ型最为常见。MC与年龄、椎体节段以及腰椎退变呈正相关,与性别无显著相关性。Objective To explore the distribution characteristics of Modic changes(MC)in patients undergoing first-time surgery for lumbar disc herniation and analyze their association with age,sex,affected segments,and the degree of intervertebral disc degeneration.Methods Clinical and imaging data of 551 patients(2755 spinal segments)who underwent first-time surgery for lumbar disc herniation between June 2018 and June 2022 at Suzhou Clinical College of Bengbu Medical University and Suzhou Municipal Hospital of Anhui Province were retrospectively analyzed.The cohort included 234 males and 317 females,aged 15 to 87 years[mean age(56.92±14.08)].Data on age,sex,affected segments,degree of intervertebral disc degeneration,and the type and distribution of MC were recorded.The distribution patterns of MC were described,and statistical analyses were conducted to evaluate the correlation between MC and lumbar disc degeneration.Results In the 2755 spinal segments analyzed,the prevalence of MC was 12.6%.MC were most frequently observed at the L 4~5 and L 5S 1 levels,accounting for 83.5%of all MC cases.MCⅡchanges were the most common,comprising 89.6%of the cases.The incidence of MC increased with age(P<0.05).The incidence of MC was slightly higher in females compared to males,though the difference was not statistically significant(P>0.05).Apositive correlation was found between the presence of MC and the degree of intervertebral disc degeneration(P<0.05).Conclusion In patients with lumbar disc herniation undergoing first-time surgery,MC is predominantly located in the lower lumbar segments,with Modic typeⅡbeing the most frequent;MC is positively correlated with age,vertebral segments,and lumbar degeneration,while no significant correlation is observed with gender.

关 键 词：腰椎间盘突出症 MODIC改变 终板炎 腰椎退行性变 

分 类 号：R681.53[医药卫生—骨科学]