An Yonghui, Li Jia, Li Yongqian, Shen Yong
Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, People's Republic of China.
The Key Laboratory of Orthopedic Biomechanics of Hebei Province, The Third Hospital of Hebei Medical University, Shijiazhuang, People's Republic of China.
J Pain Res. 2017 Jul 14;10:1657-1661. doi: 10.2147/JPR.S138361. eCollection 2017.
The purpose of this study was to evaluate characteristics of Modic changes in cervical kyphosis (CK) and their association with axial neck pain.
Study participants included 286 asymptomatic or symptomatic patients with CK (mean age = 54.2 ± 12.2 years) who were consecutively enrolled from March 2009 to October 2015. Clinical and radiographic evaluations were performed at a university outpatient department. CK was classified as global type, reverse sigmoid type, or sigmoid type.
There were 138 participants with global type CK, 103 with reverse sigmoid type CK, and 45 with sigmoid type CK. Of the 286 participants, 102 had Modic changes (Modic-1 in 38 segments and Modic-2 in 75 segments). Spinal cord compression grade and disc degeneration occurred more frequently in the group with axial neck pain compared to the group without pain. Angular motion was decreased in those with axial neck pain (mean ± standard deviation [SD] 7.8°±4.6°) compared to those who were asymptomatic (mean ± SD 8.9°±5.1°; <0.001). In multivariate logistic regression analysis, Modic changes were associated with axial neck pain (odds ratio =5.356; 95% confidence interval =1.314-12.800; <0.001).
Modic changes occur most commonly in association with CK global type and less commonly with reverse sigmoid type and sigmoid type. Modic changes are associated with axial neck pain in patients with CK.
本研究旨在评估颈椎后凸畸形(CK)中Modic改变的特征及其与颈部轴向疼痛的关联。
研究参与者包括2009年3月至2015年10月连续入选的286例无症状或有症状的CK患者(平均年龄=54.2±12.2岁)。在大学门诊部进行临床和影像学评估。CK分为整体型、反S型或S型。
有138例整体型CK参与者,103例反S型CK参与者,45例S型CK参与者。在286例参与者中,102例有Modic改变(38节段为Modic-1,75节段为Modic-2)。与无疼痛组相比,颈部轴向疼痛组的脊髓压迫分级和椎间盘退变更为常见。与无症状者相比,颈部轴向疼痛者的角运动减少(平均±标准差[SD]7.8°±4.6°)(平均±SD 8.9°±5.1°;<0.001)。在多因素逻辑回归分析中,Modic改变与颈部轴向疼痛相关(比值比=5.356;95%置信区间=1.314-12.800;<0.001)。
Modic改变最常与整体型CK相关,较少与反S型和S型相关。Modic改变与CK患者的颈部轴向疼痛相关。