Modic Ⅰ型改变可能预示着快速进展性、变形性椎间盘退变：一项为期 1 年的前瞻性随访研究。
Modic type I change may predict rapid progressive, deforming disc degeneration: a prospective 1-year follow-up study.
机构信息
Department of Radiology, Helsinki University Central Hospital, Topeliuksenkatu 5, Helsinki, Finland.
出版信息
Eur Spine J. 2012 Jun;21(6):1135-42. doi: 10.1007/s00586-012-2147-9. Epub 2012 Jan 17.
Abstract
INTRODUCTION
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.
MATERIALS AND METHODS
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.
RESULTS
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.
CONCLUSION
Endplate deformation, decreasing disc height and change of disc signal intensity appear essential features of accelerated degenerative process associated with M1.
摘要
简介
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。
材料与方法
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。
结果
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。
结论
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。
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本文引用的文献
1
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Eur Spine J. 2010 Jan;19(1):129-35. doi: 10.1007/s00586-009-1184-5. Epub 2009 Nov 18.
2
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Skeletal Radiol. 2009 Mar;38(3):237-44. doi: 10.1007/s00256-008-0611-8. Epub 2008 Dec 19.
3
MRI follow-up of subchondral signal abnormalities in a selected group of chronic low back pain patients.一组特定慢性下腰痛患者软骨下信号异常的MRI随访
Eur Spine J. 2008 Oct;17(10):1300-8. doi: 10.1007/s00586-008-0716-8. Epub 2008 Jul 22.
4
Modic changes in endplates of lumbar vertebral bodies: prevalence and association with low back and sciatic pain among middle-aged male workers.腰椎椎体终板的Modic改变：中年男性工人中的患病率及其与腰背痛和坐骨神经痛的关联
Spine (Phila Pa 1976). 2007 May 1;32(10):1116-22. doi: 10.1097/01.brs.0000261561.12944.ff.
5
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Eur Spine J. 2007 Jul;16(7):977-82. doi: 10.1007/s00586-007-0336-8. Epub 2007 Mar 3.
6
A three-year follow-up of lumbar spine endplate (Modic) changes.腰椎终板（Modic）改变的三年随访
Spine (Phila Pa 1976). 2006 Jul 1;31(15):1714-8. doi: 10.1097/01.brs.0000224167.18483.14.
7
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Spine (Phila Pa 1976). 2004 Dec 1;29(23):2654-67. doi: 10.1097/01.brs.0000148014.15210.64.
8
What is an intracluster correlation coefficient? Crucial concepts for primary care researchers.什么是组内相关系数？初级保健研究人员的关键概念。
Ann Fam Med. 2004 May-Jun;2(3):204-8. doi: 10.1370/afm.141.
9
Acquired degenerative changes of the intervertebral segments at and suprajacent to the lumbosacral junction. A radioanatomic analysis of the nondiscal structures of the spinal column and perispinal soft tissues.腰骶关节及其上方椎间节段的后天性退行性改变。脊柱非椎间盘结构及脊柱周围软组织的放射解剖学分析。
Eur J Radiol. 2004 May;50(2):134-58. doi: 10.1016/j.ejrad.2003.10.014.
10
Longitudinal study of vertebral type-1 end-plate changes on MR of the lumbar spine.腰椎磁共振成像中椎体1型终板改变的纵向研究。
Eur Radiol. 2004 Sep;14(9):1574-81. doi: 10.1007/s00330-004-2314-4. Epub 2004 Apr 2.
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