Ravikanth Reddy
Department of Radiology, Holy Family Hospital, Thodupuzha, Kerala, India.
Neurol India. 2020 Nov-Dec;68(6):1378-1384. doi: 10.4103/0028-3886.304091.
The main objectives of this study are MR characterization of disc degeneration and sequelae, analysis of lumbar disc degeneration patterns in patients with low back pain, and evaluation of the extent of involvement. This unique study evaluates the number of discs involved and the Modic changes at prolapsed, degenerated nonprolapsed, and at nondegenerated, nonprolapsed levels.
A prospective, magnetic resonance imaging-based radiological study.
A total of 1000 whole spine and lumbosacral spines were subjected to MRI examination, including spin echo with T1, T2, and STIR sequences. The Modic classification, Pfirrmann disc classification method, Borenstein criteria for central spinal canal stenosis, and Weishaupt Classification for Facet Degeneration were used for evaluation.
The commonest level of disc degeneration was L4-L5 (41.2%) and the commonest type was disc protrusion (69.4%). Disc height reduction was common at L5-S1 level (32.2%). Multidisc involvement is the commonest presentation (38.2%) followed by contiguous double level (34.7%) with disc bulges frequently reported at L3-L4 (27.2%) and L4-L5 (26.9%) levels. Majority of discs (56.1%) demonstrated Modic changes at prolapsed levels. Spondylolisthesis was commonly reported at L5-S1 level (87.5%) and was mostly associated with lumbar canal stenosis (38.4%). Posterior osteophytes were frequent at L3-L4 (31.1%) and L5-S1 (31.1%) levels. D12-L1 was least affected (4.1%) in lumbar disc degenerative disease.
The clinicians evaluated multiple variables associated with intervertebral disc degeneration and its sequelae such as lumbar canal stenosis and found the evaluation methods to be simple and practical in evaluating lumbar spine degeneration and simple communication.
本研究的主要目的是对椎间盘退变及其后遗症进行磁共振成像（MR）特征分析，分析腰痛患者的腰椎间盘退变模式，并评估受累程度。这项独特的研究评估了受累椎间盘的数量以及在椎间盘突出、退变但未突出以及未退变、未突出水平的Modic改变。
一项基于磁共振成像的前瞻性放射学研究。
对总共1000例全脊柱和腰骶椎进行了MRI检查，包括T1、T2和短TI反转恢复（STIR）序列的自旋回波成像。采用Modic分类、Pfirrmann椎间盘分类方法、中央椎管狭窄的Borenstein标准以及小关节退变的Weishaupt分类进行评估。
最常见的椎间盘退变节段是L4-L5（41.2%），最常见的类型是椎间盘突出（69.4%）。L5-S1节段椎间盘高度降低很常见（32.2%）。多节段受累是最常见的表现（38.2%），其次是相邻双节段（34.7%），L3-L4（27.2%）和L4-L5（26.9%）节段经常报告有椎间盘膨出。大多数椎间盘（56.1%）在突出节段显示有Modic改变。腰椎滑脱常见于L5-S1节段（87.5%），且大多与腰椎管狭窄相关（38.4%）。L3-L4（31.1%）和L5-S1（31.1%）节段后缘骨赘常见。在腰椎间盘退变疾病中，D12-L1受影响最小（4.1%）。
临床医生评估了与椎间盘退变及其后遗症（如腰椎管狭窄）相关的多个变量，发现这些评估方法在评估腰椎退变和进行简单沟通方面简单实用。
