Modic改变与腰痛关系的Meta分析

Meta-analysis of the relationship between Modic changes and low back pain

中文关键词:  Modic改变  腰痛  Meta分析

英文关键词:Modic changes  Low back pain  Meta analysis

中文摘要:

  【摘要】 目的：探讨MRI上Modic改变与腰痛（low back pain，LBP）的相关性。方法：通过检索MEDLINE、EMBASE和Cochrane Controlled Clinical Trials Register等电子数据库，搜集符合要求的关于Modic改变的临床研究。提取的主要数据为（1）椎间盘造影术后发生疼痛（与原腰痛症状相似）的椎间盘数和其中发生Modic改变的椎间盘数；（2）椎间盘造影术后未发生疼痛（无腰痛和未发生与原腰痛症状相似的疼痛）的椎间盘数和其中发生Modic改变椎间盘数。将其带入Meta分析软件Review Manager 4.2（下载自Cochrane Libirary）中，在随机效应模型（Random-effect model）下，用优势比（odds ratio，OR）计算结果，并进行敏感性分析。然后对Modic改变的不同亚型进行对比分析。结果：经筛选，共6篇文献纳入Meta分析。6篇文献共纳入患者966例，椎间盘3026个。椎间盘造影术后疼痛组和无疼痛组相比，OR值为3.66（95%CI，1.46～9.15）。椎间盘造影术后疼痛组1型Modic改变与2型Modic改变相比，OR值为1.31（95%CI，0.35～4.96）。结论：和无腰痛患者相比，腰痛患者的Modic改变发生率更高；与2型Modic改变相比，尚没有证据表明1型Modic改变更易引起腰痛。

英文摘要:

  【Abstract】　Objective：To determine the relationship between Modic changes and low back pain（LBP） through Meta-analysis.Method：MEDLINE，EMBASE and Cochrane Controlled Clinical Trials Register databases were carefully　searched to determine relevant papers.The parameter index for Meta-analysis included the number of symptomatic lumbar discs which pain can be provoked by discography or not（with pain similar to the primary） as well as the number with Modic changes among them.The results were brought to Review Manager 4.2（download from Cochrane Library） and measured using odds ratio（OR） under Random-effect model for sensitivity analysis.Further comparative analysis between the subgroups was performed thereafter.Result：After screening out，a total of 6 papers were meet our inclusion criterion for Meta-analysis.There were 966 cases and 3026 discs.The combined OR value for pain group and painless group after discography was 3.66（95%CI，1.46-9.15）.While the combined OR value for type 1 and type 2 Modic change in pain group after discography was 1.31（95%CI，0.35-4.96）.Conclusion：There is higher incidence rate of Modic changes in LBP patients compared with those in no LBP patients.No evidence available supports type 1 Modic changes is more relevant to low back pain.