Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.
Center for Life Course Health Research, University of Oulu, Oulu, Finland.
Spine (Phila Pa 1976). 2021 Apr 1;46(7):E415-E425. doi: 10.1097/BRS.0000000000003797.
Population-based birth cohort study.
The aim of this study was to evaluate the relationship between vertebral dimensions and lumbar MC.
Low back pain (LBP) has become the leading cause of disability worldwide. Modic changes (MC) of the lumbar spine are one potential LBP-associated etiological factor. Mechanical stress is considered to play a key role in the development of MC through damage to endplates. There is speculation that vertebral dimensions play a role in some degenerative changes in the spine. Previous studies have also shown a positive association between moderate-to-vigorous physical activity (MVPA) and both vertebral dimensions and MC. In this study, we aimed to evaluate the relationship between vertebral dimensions and MC.
The study population consisted of 1221 participants from the Northern Finland Birth Cohort 1966 who underwent lumbar magnetic resonance imaging (MRI) and physical activity measurements at the age of 46-48. The presence of Type 1 (MC1) and Type 2 (MC2) MC and the height, axial cross-sectional area (CSA), and volume of the L4 vertebra were determined from MRI scans. MVPA (≥3.5 metabolic equivalents) was measured by a wrist-worn accelerometer. We analyzed the association between lumbar MC and vertebral height, CSA, and volume using logistic regression models before and after adjustment for sex, height, weight, smoking, education level, and MVPA.
Vertebral height was positively associated with the presence of MC2 (odds ratio [OR] 3.51; 95% confidence interval [CI] 1.43-8.65), whereas vertebral CSA was not associated with the presence of lumbar MC. Vertebral volume was positively associated with the presence of any MC (OR 1.04; 95% CI 1.00-1.07), but the association did not persist when analyzing MC1 and MC2 separately.
Vertebral height was associated with the presence of MC2. Further studies are needed to clarify the role of vertebral dimensions as independent risk factors for MC.Level of Evidence: 3.
基于人群的出生队列研究。
本研究旨在评估椎体尺寸与腰椎 Modic 改变（MC）之间的关系。
下腰痛（LBP）已成为全球致残的主要原因。腰椎 Modic 改变（MC）是潜在的与 LBP 相关的病因之一。机械应力被认为通过终板损伤在 MC 的发展中起关键作用。有推测认为椎体尺寸在脊柱的一些退行性变化中起作用。先前的研究还表明，中度至剧烈体力活动（MVPA）与椎体尺寸和 MC 均呈正相关。在这项研究中，我们旨在评估椎体尺寸与 MC 之间的关系。
研究人群由参加 1966 年芬兰北部出生队列的 1221 名参与者组成，他们在 46-48 岁时接受了腰椎磁共振成像（MRI）和体力活动测量。通过 MRI 扫描确定 1 型（MC1）和 2 型（MC2）MC 的存在以及 L4 椎体的高度、轴向横截面积（CSA）和体积。MVPA（≥3.5 代谢当量）通过腕戴加速度计测量。我们使用逻辑回归模型在调整性别、身高、体重、吸烟、教育程度和 MVPA 之前和之后分析了腰椎 MC 与椎体高度、CSA 和体积之间的关系。
椎体高度与 MC2 的存在呈正相关（优势比[OR]3.51；95%置信区间[CI]1.43-8.65），而椎体 CSA 与腰椎 MC 的存在无关。椎体体积与任何 MC 的存在呈正相关（OR 1.04；95%CI 1.00-1.07），但在分别分析 MC1 和 MC2 时，这种关联并不存在。
椎体高度与 MC2 的存在相关。需要进一步的研究来阐明椎体尺寸作为 MC 独立危险因素的作用。
3。
