Department of Radiology, Helsinki University Central Hospital, Topeliuksenkatu 5, Helsinki, Finland.
Eur Spine J. 2012 Jun;21(6):1135-42. doi: 10.1007/s00586-012-2147-9. Epub 2012 Jan 17.
This prospective magnetic resonance imaging (MRI) study in chronic low-back pain (CLBP) patients evaluated the natural course of degenerative lumbar spine changes in relation to Modic 1 type changes (M1) within 1 year.
From 3,811 consecutive CLBP patients referred to lumbar spine MRI 54 patients with a large M1 were selected using strict exclusion criteria to exclude specific back disorders. Follow-up MRI was obtained within 11-18 months.
At baseline M1 was associated with an adjacent endplate lesion in 96% of the cases. In follow-up, an unstable M1 was associated both with an increase of endplate lesions, decrease of disc height and change in disc signal intensity, most found at L4/5 or L5/S1. In disc spaces without M1, progression of degenerative changes was rare.
Endplate deformation, decreasing disc height and change of disc signal intensity appear essential features of accelerated degenerative process associated with M1.
本项前瞻性磁共振成像（MRI）研究纳入慢性下腰痛（CLBP）患者，旨在评估 1 年内退变性腰椎变化与 Modic 1 型改变（M1）的自然病程。
对 3811 例连续 CLBP 患者进行腰椎 MRI 检查，采用严格排除标准选择 54 例存在大 M1 的患者，排除特定的脊柱疾病。在 11-18 个月时进行随访 MRI 检查。
基线时，M1 改变在 96%的病例中与相邻终板病变相关。在随访中，不稳定的 M1 改变与终板病变、椎间盘高度降低和椎间盘信号强度改变相关，最常见于 L4/5 或 L5/S1 水平。在没有 M1 的椎间盘间隙，退行性改变进展少见。
终板变形、椎间盘高度降低和椎间盘信号强度改变似乎是与 M1 相关的加速退行性过程的基本特征。
