颈部疼痛患者颈椎退变骨髓（Modic）改变的演变
The evolution of degenerative marrow (Modic) changes in the cervical spine in neck pain patients.
作者信息
Mann Eugen, Peterson Cynthia K, Hodler Jürg, Pfirrmann Christian W A
机构信息
Radiology Department, Orthopaedic University Hospital Balgrist, Forchstr. 340, 8008, Zürich, Switzerland,
出版信息
Eur Spine J. 2014 Mar;23(3):584-9. doi: 10.1007/s00586-013-2882-6. Epub 2013 Oct 26.
PURPOSE
To evaluate the natural course of end plate marrow (Modic) changes (MC) in the cervical spine on MRI scans of patients with neck pain. A few longitudinal studies have assessed the development of MC over time in the lumbar spine but only two recent studies evaluated MC in the cervical spine in asymptomatic volunteers and those with whiplash. Thus, this study now reports on the natural course of MC in the cervical spine in symptomatic patients.
METHODS
From the cervical MRI scans of 426 neck pain patients (mean age 61.2 years), 64 patients had follow-up MRI studies. The prevalence and types of MC were retrospectively assessed on the follow-up scans and compared to the original MRI findings.
RESULTS
With an average of 2.5 years between the two MRI scans, the prevalence of MC type 1 (MC1) noted at baseline (7.4% or 19 motion segments) slightly increased (8.2% or 21 segments) but the prevalence of MC2 (14.5% or 37 segments) increased considerably (22.3% or 57 segments). In addition, 14 new MC1 segments and 8 new MC2 segments were noted. Twelve segments with MC1 at baseline converted to MC2 at follow-up. No conversion from MC2 to MC1 or reverting to a normal image was observed.
CONCLUSIONS
MC in the cervical spine are a dynamic phenomenon similar to the lumbar spine.
目的
通过对颈部疼痛患者的MRI扫描评估颈椎终板骨髓（Modic）改变（MC）的自然病程。少数纵向研究评估了腰椎MC随时间的发展情况，但近期仅有两项研究对无症状志愿者和挥鞭样损伤患者的颈椎MC进行了评估。因此，本研究报告了有症状患者颈椎MC的自然病程。
方法
在426例颈部疼痛患者（平均年龄61.2岁）的颈椎MRI扫描中，64例患者进行了随访MRI检查。对随访扫描结果进行回顾性评估，确定MC的患病率和类型，并与原始MRI检查结果进行比较。
结果
两次MRI扫描的平均间隔时间为2.5年，基线时观察到的1型MC（MC1）患病率（7.4%或19个运动节段）略有增加（8.2%或21个节段），而2型MC（MC2）的患病率（14.5%或37个节段）显著增加（22.3%或57个节段）。此外，还发现了14个新的MC1节段和8个新的MC2节段。12个基线时为MC1的节段在随访时转变为MC2。未观察到从MC2转变为MC1或恢复至正常影像的情况。
结论
颈椎MC是一种与腰椎类似的动态现象。
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