10 年随访 MRI 研究：无症状受试者胸椎间盘与年龄相关的变化。
Ten-year Longitudinal Follow-up MRI Study of Age-related Changes in Thoracic Intervertebral Discs in Asymptomatic Subjects.
机构信息
Department of Orthopedic Surgery, Keio University School of Medicine, Tokyo, Japan.
Department of Orthopedic Surgery, Saiseikai Central Hospital, Tokyo, Japan.
出版信息
Spine (Phila Pa 1976). 2019 Nov 15;44(22):E1317-E1324. doi: 10.1097/BRS.0000000000003145.
STUDY DESIGN
Prospective longitudinal study.
OBJECTIVE
The aim of this study was to evaluate long-term degenerative changes in intervertebral discs in the thoracic spine in healthy asymptomatic subjects.
SUMMARY OF BACKGROUND DATA
Longitudinal magnetic resonance imaging (MRI) studies of intervertebral disc degeneration have been reported for the cervical and lumbar but not the thoracic spine.
METHODS
In this longitudinal study (average follow-up 10.0 ± 0.6 years), we assessed degenerative changes in the thoracic spine of 103 volunteers (58 men) of 223 healthy volunteers in the initial MRI study of the thoracic spine (follow-up rate 46.2%). The mean age at the initial study was 45.0 ± 11.5 years (24-77 years). Initial and follow-up thoracic-spine MRIs were graded for the following 4 factors of degenerative changes: decrease in signal intensity of intervertebral disc (DSI), posterior disc protrusion (PDP), anterior compression of dura and spinal cord (AC), and disc-space narrowing (DSN) from T1-2 to T12-L1. We assessed associations between changes in MRI grade and demographical factors such as age, sex, body mass index, smoking habits, sports activities, and disc degeneration in the cervical spine.
RESULTS
MRIs revealed that 63.1% of the subjects had degenerative changes in the thoracic intervertebral discs that had progressed at least one grade during the follow-up period. DSI progressed in 44.7% of subjects, PDP in 21.4%, and AC in 18.4% during the 10-year period. No DSN progression was seen. DSI was frequently observed in the upper thoracic spine (T1-2 to T4-5). Disc degeneration was relatively scarce in the lower thoracic spine (T9-10 to T12-L1). PDP was frequently observed in the middle thoracic spine (T5-6 toT8-9). We found significant associations between DSI and cervical-spine degeneration (P = .004) and between AC and smoking (P = .04).
CONCLUSION
Progressive thoracic disc degeneration, observed in 63.1% of subjects; was significantly associated with smoking and with cervical-spine degeneration.
LEVEL OF EVIDENCE
研究设计
前瞻性纵向研究。
目的
本研究旨在评估健康无症状受试者胸段脊柱椎间盘的长期退行性变化。
背景资料概要
颈椎和腰椎的椎间盘退行性纵向磁共振成像（MRI）研究已有报道，但胸段脊柱尚未报道。
方法
在这项纵向研究中（平均随访 10.0±0.6 年），我们评估了最初胸段脊柱 MRI 研究中 223 名健康志愿者中的 103 名志愿者（58 名男性）胸段脊柱退行性变化的情况（随访率为 46.2%）。最初研究时的平均年龄为 45.0±11.5 岁（24-77 岁）。对初始和随访的胸段 MRI 进行了以下 4 个退行性变化因素的分级：椎间盘信号强度降低（DSI）、椎间盘后突（PDP）、硬脑膜和脊髓前压迫（AC）以及 T1-2 至 T12-L1 的椎间盘间隙变窄（DSN）。我们评估了 MRI 分级与年龄、性别、体重指数、吸烟习惯、运动活动以及颈椎间盘退变等人口统计学因素之间的关系。
结果
MRI 显示，63.1%的受试者胸椎间盘有退行性变化，在随访期间至少有一个等级进展。44.7%的受试者出现 DSI 进展，21.4%的受试者出现 PDP 进展，18.4%的受试者出现 AC 进展。在 10 年期间未观察到 DSN 进展。DSI 在上胸段（T1-2 至 T4-5）更为常见。下胸段（T9-10 至 T12-L1）的椎间盘退变相对较少。PDP 在上胸段（T5-6 至 T8-9）更为常见。我们发现 DSI 与颈椎间盘退变（P=0.004）和 AC 与吸烟（P=0.04）之间存在显著相关性。
结论
63.1%的受试者出现进展性胸椎间盘退变，与吸烟和颈椎间盘退变显著相关。
证据水平
2。
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