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颈椎间盘退变患者颈部疼痛的相关预测因素:一项聚焦于Modic改变的横断面研究。

Predictive factors associated with neck pain in patients with cervical disc degeneration: A cross-sectional study focusing on Modic changes.

作者信息

Kong Lingde, Tian Weifeng, Cao Peng, Wang Haonan, Zhang Bing, Shen Yong

机构信息

Department of Orthopedics, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, P.R. China.

出版信息

Medicine (Baltimore). 2017 Oct;96(43):e8447. doi: 10.1097/MD.0000000000008447.

Abstract

The predictive factors associated with neck pain remain unclear. We conducted a cross-sectional study to assess predictive factors, especially Modic changes (MCs), associated with the intensity and duration of neck pain in patients with cervical disc degenerative disease.We retrospectively reviewed patients in our hospital from January 2013 to December 2016. Severe neck pain (SNP) and persistent neck pain (PNP) were the 2 main outcomes, and were assessed based on the numerical rating scale (NRS). Basic data, and also imaging data, were collected and analyzed as potential predictive factors. Univariate analysis and multiple logistic regression analysis were performed to assess the predictive factors for neck pain.In all, 381 patients (193 males and 188 females) with cervical degenerative disease were included in our study. The number of patients with SNP and PNP were 94 (24.67%) and 109 (28.61%), respectively. The NRS of neck pain in patients with type 1 MCs was significantly higher than type 2 MCs (4.8 ± 0.9 vs 3.9 ± 1.1; P = .004). The multivariate logistic analysis showed that kyphosis curvature (odds ratio [OR] 1.082, 95% confidence interval [CI] 1.044-1.112), spondylolisthesis (OR 1.339, 95% CI 1.226-1.462), and annular tear (OR 1.188, 95% CI 1.021-1.382) were factors associated with SNP, whereas kyphosis curvature (OR 1.568, 95% CI 1.022-2.394), spondylolisthesis (OR 1.486, 95% CI 1.082-2.041), and MCs (OR 1.152, 95% CI 1.074-1.234) were associated with PNP.We concluded that kyphosis curvature, spondylolisthesis, and annular tear are associated with SNP, whereas kyphosis curvature, spondylolisthesis, and MCs are associated with PNP. This study supports the view that MCs can lead to a long duration of neck pain.

摘要

与颈部疼痛相关的预测因素仍不明确。我们进行了一项横断面研究,以评估与颈椎间盘退变疾病患者颈部疼痛的强度和持续时间相关的预测因素,尤其是Modic改变(MCs)。我们回顾性分析了2013年1月至2016年12月我院的患者。重度颈部疼痛(SNP)和持续性颈部疼痛(PNP)是两个主要结局,并根据数字评分量表(NRS)进行评估。收集并分析基本数据以及影像数据作为潜在的预测因素。进行单因素分析和多因素逻辑回归分析以评估颈部疼痛的预测因素。

本研究共纳入381例颈椎退变疾病患者(男性193例,女性188例)。SNP患者和PNP患者的数量分别为94例(24.67%)和109例(28.61%)。1型MCs患者的颈部疼痛NRS显著高于2型MCs患者(4.8±0.9 vs 3.9±1.1;P = 0.004)。多因素逻辑分析显示,后凸畸形(比值比[OR] 1.082,95%置信区间[CI] 1.044 - 1.112)、椎体滑脱(OR 1.339,95% CI 1.226 - 1.462)和椎间盘环撕裂(OR 1.188,95% CI 1.021 - 1.382)是与SNP相关的因素,而后凸畸形(OR 1.568,95% CI 1.022 - 2.394)、椎体滑脱(OR 1.486,95% CI 1.082 - 2.041)和MCs(OR 1.152,95% CI 1.074 - 1.234)与PNP相关。

我们得出结论,后凸畸形、椎体滑脱和椎间盘环撕裂与SNP相关,而后凸畸形、椎体滑脱和MCs与PNP相关。本研究支持MCs可导致颈部疼痛持续时间延长的观点。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e6b0/5671881/a9a0cfdb07f9/medi-96-e8447-g001.jpg

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