颈椎间盘突出与颈椎间盘退变程度相关：一项对1211名相对健康志愿者的横断面研究。
Cervical Disc Protrusion Correlates With the Severity of Cervical Disc Degeneration: A Cross-Sectional Study of 1211 Relatively Healthy Volunteers.
作者信息
Nakashima Hiroaki, Yukawa Yasutsugu, Suda Kota, Yamagata Masatsune, Ueta Takayoshi, Kato Fumihiko
机构信息
*Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan †Department of Orthopedic Surgery, Chubu Rosai Hospital, Nagoya, Japan ‡Department of Orthopedic Surgery, Hokkaido Chuo Rosai Hospital Sekison Center, Hokkaido, Japan §Department of Orthopedic Surgery, Chiba Rosai Hospital, Chiba, Japan; and ¶Department of Orthopedic Surgery, Spinal Injuries Center, Izuka, Japan.
出版信息
Spine (Phila Pa 1976). 2015 Jul 1;40(13):E774-9. doi: 10.1097/BRS.0000000000000953.
STUDY DESIGN
Cross-sectional study.
OBJECTIVE
The purposes of this study were (1) to investigate the frequency and degree of cervical disc degeneration and protrusion on cervical spine magnetic resonance (MR) images and (2) to analyze the correlation between the severity of disc degeneration and disc protrusion.
SUMMARY OF BACKGROUND DATA
Cervical disc degenerative changes or protrusion is commonly observed on MR images in healthy subjects. However, there are few large-scale studies, and the frequency and range of these findings in healthy subjects have not been clarified. Moreover, there are no reports regarding the correlation between cervical disc degeneration and disc protrusion.
METHODS
Cervical disc degeneration and protrusion were prospectively measured using magnetic resonance imaging in 1211 relatively healthy volunteers. These included at least 100 males and 100 females in each decade of life between the 20s and the 70s. Cervical disc degeneration was defined according to the modified Pfirrmann classification system, and the amount of disc protrusion was evaluated using the anteroposterior diameter of disc protrusion on sagittal MR image.
RESULTS
Mild disc degeneration was very common, including 98.0% of both sexes in their 20s. The severity of cervical disc degeneration significantly increased with age in both sexes at every level. The disc degeneration predominantly occurred at C5-C6 and C6-C7. The difference between sexes was not significant except for individuals in their 50s. The average anteroposterior diameter of disc protrusion increased with aging, especially from the 20s to the 40s. The anteroposterior diameter of disc protrusion increased with a progression in the disc degeneration grade.
CONCLUSION
Cervical disc degeneration and protrusion were frequently observed in healthy subjects even in their 20s and deteriorated with age. Cervical disc protrusion was significantly correlated with cervical disc degeneration, and spatial cervical disc protrusion was affected by biochemical degenerative changes as observed on MR images.
LEVEL OF EVIDENCE
研究设计
横断面研究。
目的
本研究的目的是（1）调查颈椎磁共振（MR）图像上颈椎间盘退变和突出的频率及程度，以及（2）分析椎间盘退变严重程度与椎间盘突出之间的相关性。
背景资料总结
在健康受试者的MR图像上常见颈椎间盘退变或突出。然而，大规模研究较少，健康受试者中这些发现的频率和范围尚未明确。此外，尚无关于颈椎间盘退变与椎间盘突出之间相关性的报道。
方法
对1211名相对健康的志愿者进行颈椎磁共振成像，前瞻性测量颈椎间盘退变和突出情况。这些志愿者年龄在20岁至70岁之间，每个十年年龄段至少有100名男性和100名女性。根据改良的Pfirrmann分类系统定义颈椎间盘退变，并使用矢状面MR图像上椎间盘突出的前后径评估椎间盘突出量。
结果
轻度椎间盘退变非常常见，20多岁的男女中均有98.0%存在。在每个节段，颈椎间盘退变的严重程度在男女中均随年龄显著增加。椎间盘退变主要发生在C5-C6和C6-C7。除50多岁的个体外，性别差异不显著。椎间盘突出的平均前后径随年龄增长而增加，尤其是从20多岁到40多岁。椎间盘突出的前后径随椎间盘退变程度的进展而增加。
结论
即使在20多岁的健康受试者中也经常观察到颈椎间盘退变和突出，且随年龄恶化。颈椎间盘突出与颈椎间盘退变显著相关，并且如MR图像所示，颈椎间盘突出的空间情况受生化退变变化的影响。
证据水平
2级。
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