Cheung Kenneth M C, Karppinen Jaro, Chan Danny, Ho Daniel W H, Song You-Qiang, Sham Pak, Cheah Kathryn S E, Leong John C Y, Luk Keith D K
Department of Orthopaedics and Traumatology, University of Hong Kong, Hong Kong, China.
Spine (Phila Pa 1976). 2009 Apr 20;34(9):934-40. doi: 10.1097/BRS.0b013e3181a01b3f.
A cross-sectional population study of magnetic resonance imaging (MRI) changes. OBJECTIVE.: To examine the pattern and prevalence of lumbar spine MRI changes within a southern Chinese population and their relationship with back pain.
Previous studies on MRI changes and back pain have used populations of asymptomatic individuals or patients presenting with back pain and sciatica. Thus, the prevalence and pattern of intervertebral disc degeneration within the population is not known.
Lumbar spine MRIs were obtained in 1043 volunteers between 18 to 55 years of age. MRI changes including disc degeneration, herniation, anular tears (HIZ), and Schmorl's nodes were noted by 2 independent observers. Differences were settled by consensus. Disc degeneration was graded using Schneiderman's classification, and a total score (DDD score) was calculated by the summation of the Schneiderman's score for each lumbar level. A K-mean clustering program was used to group individuals into different patterns of degeneration.
Forty percent of individuals under 30 years of age had lumbar intervertebral disc degeneration (LDD), the prevalence of LDD increasing progressively to over 90% by 50 to 55 years of age. There was a positive correlation between the DDD score and low back pain. L5-S1 and L4-L5 were the most commonly affected levels. Apart from the usual patterns of degeneration, some uncommon patterns of degeneration were identified, comprising of subjects with skip level lesions (intervening normal levels) and isolated upper or mid lumbar degeneration.
LDD is common, and its incidence increases with age. In a population setting, there is a significant association of LDD on MRI with back pain.
一项关于磁共振成像（MRI）变化的横断面人群研究。目的：研究中国南方人群腰椎MRI变化的模式和患病率及其与背痛的关系。
以往关于MRI变化与背痛的研究使用的是无症状个体或有背痛和坐骨神经痛症状的患者群体。因此，该人群中椎间盘退变的患病率和模式尚不清楚。
对1043名年龄在18至55岁之间的志愿者进行腰椎MRI检查。两名独立观察者记录MRI变化，包括椎间盘退变、突出、环状撕裂（HIZ）和许莫氏结节。分歧通过协商解决。采用施奈德曼分类法对椎间盘退变进行分级，并通过对每个腰椎节段的施奈德曼评分求和计算总分（DDD评分）。使用K均值聚类程序将个体分为不同的退变模式。
30岁以下个体中40%存在腰椎间盘退变（LDD），到50至55岁时，LDD患病率逐渐上升至90%以上。DDD评分与腰痛呈正相关。L5-S1和L4-L5是最常受累的节段。除了常见的退变模式外，还发现了一些不常见的退变模式，包括有跳跃节段病变（中间正常节段）的受试者以及孤立的上腰椎或中腰椎退变。
LDD很常见，其发病率随年龄增长而增加。在人群中，MRI上的LDD与背痛存在显著关联。
