MRI上腰椎终板信号改变的影响因素分析———性别、体重、劳动量及吸烟与Modic改变的相关性

Correlative factors for MRI signal changes of lumbar endplate，a correlation study between sex，weight，quantity of work，smoking and Modic changes

中文关键词:  腰椎  Modic改变  椎间盘  终板  MRI

英文关键词:Lumbar vertebra Modic changes  Ｉntervertebral disc  Vertebral endplate  MRI

中文摘要:

  【摘要】 目的：探讨腰腿痛患者腰椎ＭＲＩ上终板Modic改变的分布特点及其相关因素。方法：回顾性分析我院2009年2月～2010年10月收治的210例腰腿痛患者腰椎MRI中Modic改变的发生率及类型，并评估Modic改变与性别、体重、劳动量及吸烟等因素的相关性。结果：47例患者共58个椎间盘邻近椎板存在Modic 改变，占入选患者的22.4%。其中男16例；女31例，Modic Ⅰ型、Ⅱ型和Ⅲ型的人数分别为16例、25例、6例，出现Modic改变的节段为L5/S1（28个）、L4/5（17个）、L3/4（9个）、L2/3（4个）。在肥胖人群中Ｍｏｄｉｃ改变的发生率高于正常体重和超重人群（P<0.05），重体力劳动者的发生率高于一般劳动者（P<0.05），劳动量和体重与ModicⅢ型改变有相关性（P<0.05），与其他分型无明显相关性（P>0.05）。吸烟与Modic改变无明显相关性（P>0.05）。结论：患者的性别、体重及劳动量等因素与Modic改变的发生具有相关性，生物力学损伤可能在Modic改变中发挥着重要作用。

英文摘要:

  【Abstract】 Objective：To investigate the distribution of patient with Modic changes in lumbar endplate and evaluate the relationship between Modic changes and several influence factors.Method：The T1-weight and T-2weight sagittal MRI scans of 210 patients who sustained sciatica were reviewed retrospectively.The patient′s weight，gender，status of smoking，physical activity and specific type of Modic changes were recorded，and the association between Modic changes and those influence factors was analyzed.Result：Modic changes were observed in 47 patients（22.4%），including 16　males and　31　females.The most frequent lumbar spinal levels suffering Modic changes was L5/S1.Among all the patients，there were 16 type Ⅰ；25 type Ⅱ；and 6　type Ⅲ.Modic changes occurred more often in　obese　patients than in normal and overweight patients（P<0.05）.Patients whose job requires more labour were more apt to develop Modic change（P<0.05）．Labour and weight were related to type III Modic change（P>0.05）rather than other types （P>0.05）.Smoking seems not correlated to the incidence of Modic changes（P>0.05）.Conclusion：The sex，body weight and labour are associated with Modic change.Biomechanical factors may play a critical role in the incidence of Modic changes．