Université Paris Descartes, Sorbonne Paris Cité, Paris, France.
Service de Rééducation et de Réadaptation de l'Appareil Locomoteur et des Pathologies du Rachis, Hôpitaux Universitaires Paris Centre-Groupe Hospitalier Cochin, Assistance Publique-Hôpitaux de Paris, Paris, France.
PLoS One. 2018 Jun 29;13(6):e0196536. doi: 10.1371/journal.pone.0196536. eCollection 2018.
We aimed to compare bone mineral density (BMD) and bone remodeling markers in chronic low back pain (cLBP) patients with and without active discopathy (Modic 1 changes).
We conducted a single center case-control exploratory study. For 18 months, all patients referred to a tertiary care physical medicine and rehabilitation department in France were consecutively screened. Patients fulfilling the inclusion criteria were prospectively enrolled. Cases were defined as cLBP patients with lumbar active discopathy detected on MRI and controls as cLBP patients without active discopathy. Bone mineral density (BMD) at the spine, femoral neck and total femur was assessed by dual-energy X-ray absorptiometry, and bone remodeling markers were assessed in fasting serum samples. Overall, 37 cLBP patients (13 cases and 24 controls) fulfilled inclusion criteria and were included.
The median age was 42.0 years (Q1-Q3: 36.0-51.0) and mean (SD) LBP duration 72.3 (57.4) months. We found that BMD and levels of bone remodeling markers in cLBP patients did not differ with and without active discopathy.
Our results do not support the association between active discopathy and systemic bone fragility.
本研究旨在比较慢性下腰痛（cLBP）伴和不伴活动性椎间盘病（Modic 1 改变）患者的骨密度（BMD）和骨重塑标志物。
我们进行了一项单中心病例对照探索性研究。在 18 个月的时间里，连续筛选了所有被转诊到法国一家三级保健物理医学和康复科的患者。符合纳入标准的患者被前瞻性纳入。病例定义为 MRI 显示腰椎活动性椎间盘病的 cLBP 患者，对照组为无活动性椎间盘病的 cLBP 患者。通过双能 X 射线吸收法评估脊柱、股骨颈和全股骨的骨密度（BMD），并在空腹血清样本中评估骨重塑标志物。共有 37 名 cLBP 患者（13 例病例和 24 例对照）符合纳入标准并被纳入。
中位年龄为 42.0 岁（Q1-Q3：36.0-51.0），平均（SD）腰痛持续时间为 72.3（57.4）个月。我们发现，cLBP 患者的 BMD 和骨重塑标志物水平在伴和不伴活动性椎间盘病时无差异。
我们的结果不支持活动性椎间盘病与全身骨脆弱之间的关联。
