Ristolainen Leena, Kettunen Jyrki A, Danielson Heidi, Heliövaara Markku, Schlenzka Dietrich
Orton Orthopaedic Hospital, Helsinki, Finland, Tenholantie 10, PL 29, 00281, Helsinki, Finland.
Arcada, University of Applied Sciences, Jan-Magnus Janssonin aukio 1, 00560, Helsinki, Finland.
J Orthop. 2020 Feb 4;21:69-74. doi: 10.1016/j.jor.2020.02.004. eCollection 2020 Sep-Oct.
There are only a few studies on untreated Scheuermann's disease and magnetic resonance imaging (MRI) findings in the lumbar spine. The primary aim of this study was to clarify lumbar MRI findings in patients with Scheuermann's disease and to compare with subjects without diagnosed spine disease.
Twenty-two male adult Scheuermann's patients (mean age 64.7 years (Standard Deviation [SD] 6.4) and 26 males (mean age 59.7 years [SD 7.4]) from a national health survey were included in this study. From MR images, the dimensions of the vertebral bodies, intervertebral discs and the dural sac were measured. Spondylolisthesis, Modic changes (MC), high intensity zone values (HIZ), and Schmorl's nodes were registered from both groups as well as self-reported data concerning general health, quality of life, and back pain symptoms.
Significantly more patients with Scheuermann's disease had at least one MC compared to the controls at the level L1/L2 (Odds Ratio [OR] 21.11, 95% Confidence Interval [95% CI] 2.31-192.96), at the level L3/L4 (OR 13.62, 95% CI 1.41-131.26), and at the level L5/S1 (OR 6.11, 95% CI 1.50-24.83). Patients had significantly more Schmorl's nodes compared to the controls (64% vs. 8%, p < 0.001). The area of the dura sac (L3/L4) was larger (mean 201 mm vs. 152 mm, p = 0.017) in the patients compared to controls. At level L1/L2 patients had higher disc than controls (mean 7.9 mm vs. 6.8 mm, p = 0.038). After adjusting for age patients had more commonly constant back pain (OR 9.4, 95% CI 1.56-56.97), and difficulties in walking up one floor without resting (OR 9.8, 95% CI 1.01-95.34) than controls.
Schmorl's nodes and Modic changes on lumbar MRI, back pain and physical function restrictions seem to be more prevalent among patients with Scheuermann's disease than in the general population.
关于未经治疗的休门氏病及腰椎磁共振成像（MRI）表现的研究较少。本研究的主要目的是明确休门氏病患者的腰椎MRI表现，并与未诊断出脊柱疾病的受试者进行比较。
本研究纳入了22名成年男性休门氏病患者（平均年龄64.7岁，标准差[SD]6.4）和26名来自全国健康调查的男性（平均年龄59.7岁，SD 7.4）。从MR图像上测量椎体、椎间盘和硬脊膜囊的尺寸。记录两组的椎体滑脱、Modic改变（MC）、高强度区值（HIZ）和许莫氏结节，以及有关总体健康、生活质量和背痛症状的自我报告数据。
与对照组相比，休门氏病患者在L1/L2水平（优势比[OR]21.11，95%置信区间[95%CI]2.31 - 192.96）、L3/L4水平（OR 13.62，95%CI 1.41 - 131.26）和L5/S1水平（OR 6.11，95%CI 1.50 - 24.83）至少有一处MC的患者明显更多。与对照组相比，患者的许莫氏结节明显更多（64%对8%，p < 0.001）。与对照组相比，患者的硬脊膜囊面积（L3/L4）更大（平均201mm对152mm，p = 0.017）。在L1/L2水平，患者的椎间盘比对照组更高（平均7.9mm对6.8mm，p = 0.038）。在调整年龄后，患者比对照组更常出现持续性背痛（OR 9.4，95%CI 1.56 - 56.97），以及不休息爬一层楼有困难（OR 9.8，95%CI 1.01 - 95.34）。
腰椎MRI上的许莫氏结节和Modic改变、背痛及身体功能受限在休门氏病患者中似乎比一般人群更普遍。
