Waris Eero, Eskelin Marja, Hermunen Heikki, Kiviluoto Olli, Paajanen Hannu
Department of Surgery and Radiology, Central Military Hospital, Helsinki, Finland.
Spine (Phila Pa 1976). 2007 Mar 15;32(6):681-4. doi: 10.1097/01.brs.0000257523.38337.96.
A prospective, cohort clinical and magnetic resonance imaging (MRI) study of patients with low back pain.
To study if lumbar disc degeneration (DD), diagnosed in young patients with low back pain by using MRI will predict chronic pain, disc herniation, or functional disability after a 17-year follow-up.
In 1987, 75 male Finnish conscripts aged 20 years, with low back pain hindering their military service, were studied using MRI at 0.02 T.
In 2003, 32 patients were reexamined with MRI at 1.0 T. The history of low back illness during the follow-up and current functional outcome were recorded.
In 1987, 69% of the 32-patient cohort had DD in one or more lumbar discs. In 2003, all subjects had DD in MRI. The mean number of degenerated discs in each subject increased from 1.1 to 3.0. A total of 76% of discs degenerated in 1987 were herniated in 2003, whereas only 29% of well-hydrated discs in 1987 were herniated at the time of follow-up (P = 0.0002). During 17 years of follow-up, 3 patients had undergone spinal surgery.
Early DD in adolescent patients with low back pain predicted the evolution of enhanced DD and herniation in adulthood, but it was not associated with severe low back pain or increased frequency of spinal surgery.
一项针对腰痛患者的前瞻性队列临床及磁共振成像（MRI）研究。
研究通过MRI诊断为腰椎间盘退变（DD）的年轻腰痛患者在17年随访后是否会出现慢性疼痛、椎间盘突出或功能障碍。
1987年，对75名年龄20岁、因腰痛妨碍服兵役的芬兰男性应征入伍者使用0.02T的MRI进行了研究。
2003年，对32名患者用1.0T的MRI进行复查。记录随访期间的腰痛病史及当前功能结局。
1987年，该32名患者队列中69%的患者存在一个或多个腰椎间盘退变。2003年，所有受试者在MRI检查中均存在椎间盘退变。每名受试者退变椎间盘的平均数量从1.1个增加到3.0个。1987年退变的椎间盘中有76%在2003年发生了突出，而1987年水分充足的椎间盘在随访时只有29%发生了突出（P = 0.0002）。在17年的随访期间，3名患者接受了脊柱手术。
青少年腰痛患者早期的椎间盘退变预示着成年期椎间盘退变加剧及椎间盘突出的发展，但与严重腰痛或脊柱手术频率增加无关。
