Ogon Izaya, Takashima Hiroyuki, Morita Tomonori, Oshigiri Tsutomu, Terashima Yoshinori, Yoshimoto Mitsunori, Fukushi Ryunosuke, Fujimoto Shutaro, Emori Makoto, Teramoto Atsushi, Takebayashi Tsuneo, Yamashita Toshihiko
Department of Orthopaedic Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan.
Department of Orthopaedic Surgery, Sapporo Maruyama Orthopaedic Hospital, Sapporo, Japan.
Asian Spine J. 2020 Oct;14(5):621-628. doi: 10.31616/asj.2019.0231. Epub 2020 Mar 30.
Cross-sectional study.
The purpose of this study was to elucidate the relevance among Schmorl's node (SN), chronic low back pain (CLBP), and intervertebral disc degeneration (IVDD) with the use of magnetic resonance imaging T2 mapping.
SN may be combined with CLBP and/or IVDD; however, their relationship has not been determined to date.
A total of 105 subjects were included (48 men and 57 women; mean age, 63.2±2.7 years; range, 22-84 years). We analyzed five functional spinal unit levels (L1-S1) and evaluated the T2 values of the anterior annulus fibrosus (AF), nucleus pulposus, and posterior AF. We compared the low back pain (LBP) Visual Analog Scale (VAS) scores and the T2 values in each decade with or without SN.
There were no remarkable differences in SN prevalence rate regarding age decade or gender. SNs were more prevalent in the upper 2 levels (70.3%). LBP VAS scores with and without SN were 64.7±4.3 mm and 61.9±2.8 mm, respectively, with no significant differences between the groups (p=0.62). The T2 values of anterior AF with SN were significantly lower than those without SN in patients in their 50s, 60s, 70s, and 80s (p<0.01).
SN presence is not itself a risk factor for CLBP; however, it indicates IVDD of the anterior AF in subjects with SN who are ≥50 years old.
横断面研究。
本研究的目的是通过磁共振成像T2映射来阐明施莫尔氏结节(SN)、慢性下腰痛(CLBP)和椎间盘退变(IVDD)之间的相关性。
SN可能与CLBP和/或IVDD相关;然而,它们之间的关系迄今尚未确定。
共纳入105名受试者(48名男性和57名女性;平均年龄63.2±2.7岁;范围22 - 84岁)。我们分析了五个功能脊柱单元水平(L1 - S1),并评估了纤维环前部(AF)、髓核和纤维环后部的T2值。我们比较了有或无SN的每个十年中的下腰痛(LBP)视觉模拟量表(VAS)评分和T2值。
SN患病率在年龄十年或性别方面无显著差异。SN在上2个水平更常见(70.3%)。有和无SN的LBP VAS评分分别为64.7±4.3 mm和61.9±2.8 mm,两组之间无显著差异(p = 0.62)。在50多岁、60多岁、70多岁和80多岁的患者中,有SN的纤维环前部T2值显著低于无SN的患者(p < 0.01)。
存在SN本身不是CLBP的危险因素;然而,它表明≥50岁有SN的受试者纤维环前部存在IVDD。