Department of Orthopeadic Surgery, The First Hospital of Shijiazhang, Shijiazhang, China.
Spine (Phila Pa 1976). 2012 Nov 1;37(23):1958-64. doi: 10.1097/BRS.0b013e31825bfb85.
A retrospective study of modic changes (MCs) in degenerative lumbar scoliosis (DLS).
To investigate the prevalence of vertebral endplate MCs in DLS and explore their associated factors.
MCs are common in spinal degenerative diseases. Presently, most of the researches have been focused on investigating the relationship between MCs and chronic low back pain. Little has been known on the distribution of MCs in DLS and the relationship between MCs and scoliosis.
The image data of 120 patients who had been diagnosed with DLS in our hospital from March 2005 to March, 2011 were retrospectively reviewed as the study group. The image data of 89 patients who had been diagnosed with degenerative lumbar diseases without scoliosis were selected as the control group. The prevalence, type, and distribution of MCs in 2 groups were observed and compared. Disc degeneration, Cobb angle, body weight, and smoking were recorded in the study group, and the relationship of MCs with these influential factors was analyzed.
Of 1440 endplates from 120 patients in the study group, 247 (17.2%) from 71 (59.2%) patients were found to have MCs. Compared with the control group, of 1068 endplates from 89 patients, 49 (4.5%) endplates from 21 (23.6%) patients were found to have MCs. The prevalence of MCs was significantly higher in the study group than that in the control group (P < 0.01). The MCs in DLS usually had asymmetric distribution with more frequent occurrence on the concave side than on the convex side of major or compensatory curve and mainly occurred at L2-L3, L4-L5, and L5-S1, which were in accordance with the common levels of apex vertebrae. Intervertebral disc degeneration, lumbar scoliosis, overweight and heavy smoking are considered as risk factors to MCs. By multinomial logistic regression analysis on these factors, the regression function was obtained: logit Y = -0.82 + 1.27D + 0.55S + 1.77 D × S (Y for MCs, D for intervertebral disc degeneration, S for scoliosis Cobb's angle and D × S for interaction of D and S).
The prevalence of MCs in patients with DLS was significantly higher than that of patients without DLS. Most of them were type 2 and usually located on the concave side of apex vertebrae. MCs were significantly associated with intervertebral disc degeneration and lumbar scoliosis.
退行性腰椎侧凸（DLS）中 Modic 改变（MCs）的回顾性研究。
研究 DLS 中椎体终板 MCs 的发生率，并探讨其相关因素。
MCs 在脊柱退行性疾病中很常见。目前，大多数研究都集中在研究 MCs 与慢性下腰痛之间的关系上。关于 DLS 中 MCs 的分布以及 MCs 与脊柱侧凸之间的关系，人们知之甚少。
回顾性分析 2005 年 3 月至 2011 年 3 月我院收治的 120 例 DLS 患者的影像学资料，作为研究组。选择 89 例无脊柱侧凸的退行性腰椎疾病患者的影像学资料作为对照组。观察并比较两组 MCs 的发生率、类型和分布。记录研究组的椎间盘退变、Cobb 角、体重和吸烟情况，并分析 MCs 与这些影响因素的关系。
在研究组的 120 例患者的 1440 个终板中，71 例（59.2%）247 个（17.2%）终板有 MCs。与对照组相比，89 例患者的 1068 个终板中，21 例（23.6%）患者的 49 个终板（4.5%）有 MCs。研究组 MCs 的发生率明显高于对照组（P <0.01）。DLS 中的 MCs 通常呈不对称分布，在主或代偿曲线上凹侧的发生率高于凸侧，主要发生在 L2-L3、L4-L5 和 L5-S1，与顶椎的常见水平一致。椎间盘退变、腰椎侧凸、超重和大量吸烟被认为是 MCs 的危险因素。对这些因素进行多项逻辑回归分析，得到回归函数：logit Y =-0.82 +1.27D +0.55S +1.77 D × S（Y 为 MCs，D 为椎间盘退变，S 为脊柱侧弯 Cobb 角，D×S 为 D 和 S 的交互作用）。
DLS 患者 MCs 的发生率明显高于无 DLS 患者。大多数为 2 型，通常位于顶椎的凹侧。MCs 与椎间盘退变和腰椎侧凸明显相关。
