腰椎间盘突出症患者 MRI 颈椎间盘退变:与无症状志愿者的对比研究。

Disc degeneration of cervical spine on MRI in patients with lumbar disc herniation: comparison study with asymptomatic volunteers.

机构信息

Department of Orthopaedic Surgery, Keio University, Shinanomachi 35, Shinjuku-ku, Tokyo 160-8582, Japan.

出版信息

Eur Spine J. 2011 Apr;20(4):585-91. doi: 10.1007/s00586-010-1644-y. Epub 2010 Dec 3.

Abstract

An association between progression of cervical disc degeneration and that of lumbar disc degeneration has been considered to exist. To date, however, this association has not yet been adequately studied. Age-related changes in the cervical intervertebral discs were evaluated by magnetic resonance imaging (MRI) in patients with lumbar disc herniation, and compared with the MRI findings of healthy volunteers without lower back pain. The purpose of this study was to clarify whether the prevalence of asymptomatic cervical disc degeneration is higher in patients with lumbar disc herniation than in healthy volunteers. The study was conducted on 51 patients who were diagnosed as having lumbar disc herniation and underwent cervical spine MRI. The patients consisted of 34 males and 17 females ranging in age from 21-83 years (mean 46.9 ± 14.5 years) at the time of the study. The control group was composed of 113 healthy volunteers (70 males and 43 females) aged 24-77 years (mean 48.9 ± 14.7 years), without neck pain or low back pain. The percentage of subjects with degenerative changes in the cervical discs was 98.0% in the lumbar disc herniation group and 88.5% in the control group (p = 0.034). The presence of lumbar disc herniation was associated significantly with decrease in signal intensity of intervertebral disc and posterior disc protrusion in the cervical spine. None of the MRI findings was significantly associated with the gender, smoking, sports activities, or BMI. As compared to healthy volunteers, patients with lumbar disc herniation showed a higher prevalence of decrease in signal intensity of intervertebral disc and posterior disc protrusion on MRI of the cervical spine. The result of this study suggests that disc degeneration appears to be a systemic phenomenon.

摘要

颈椎间盘退变与腰椎间盘退变之间存在关联。然而,到目前为止,这种关联尚未得到充分研究。本研究通过磁共振成像(MRI)评估了腰椎间盘突出症患者颈椎间盘的年龄相关性变化,并与无下腰痛的健康志愿者的 MRI 结果进行了比较。本研究旨在阐明腰椎间盘突出症患者无症状性颈椎间盘退变的发生率是否高于健康志愿者。本研究纳入了 51 例经诊断为腰椎间盘突出症并接受颈椎 MRI 检查的患者。患者中男 34 例,女 17 例,年龄 21-83 岁(研究时的平均年龄为 46.9±14.5 岁)。对照组由 113 名无颈痛或腰痛的健康志愿者组成(男 70 名,女 43 名),年龄 24-77 岁(研究时的平均年龄为 48.9±14.7 岁)。颈椎间盘退行性改变的患者比例为腰椎间盘突出症组 98.0%,对照组 88.5%(p=0.034)。腰椎间盘突出症与颈椎间盘信号强度降低和后突有关。MRI 结果与性别、吸烟、运动活动或 BMI 均无显著相关性。与健康志愿者相比,腰椎间盘突出症患者颈椎间盘 MRI 上的椎间盘信号强度降低和后突更为常见。本研究结果表明,椎间盘退变似乎是一种系统性现象。

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