Modic 改变与相邻腰椎间盘麻醉后疼痛缓解更大相关：慢性下腰痛患者的回顾性研究。
Modic changes associated with greater pain relief following anesthetization of the adjacent lumbar intervertebral disc: A retrospective study of chronic low back pain patients.
机构信息
Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, PO Box 5000, 90014 Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, PO Box 8000, 90014 Oulu, Finland.
Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, PO Box 5000, 90014 Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, PO Box 8000, 90014 Oulu, Finland; Department of Diagnostic Radiology, Oulu University Hospital, PO Box 50, 90029 OYS, Oulu, Finland.
出版信息
Eur J Radiol. 2022 Dec;157:110589. doi: 10.1016/j.ejrad.2022.110589. Epub 2022 Nov 1.
PURPOSE
To assess the correlation between the degree of pain relief following discoblock and the presence and type of adjacent Modic changes (MC).
METHOD
We retrospectively analyzed chronic low back pain (LBP) patients whose pain was suspected to originate from a specific lumbar intervertebral disc (IVD) based on a spine orthopedist's clinical evaluation and magnetic resonance imaging (MRI). Thus, patients were selected to undergo discoblock. We calculated the degree of pain relief following discoblock on Numerical Rating Scale (ΔNRS) and analyzed the MRIs on the basis of MC presence and type on the lumbar spinal segment in question. We assessed the differences in ΔNRS between the groups with absent and present MC and the groups of MC subtypes.
RESULTS
Forty-five patients were included in the present study, all of whom underwent discoblock at a single level. The total MC prevalence was 77.8 % (35 patients); pure or dominant MC type 1 (MC1 group) 35.6 % (16 patients); and pure or dominant MC type 2 (MC2 group) 42.2 % (19 patients). ΔNRS was significantly greater in the group with MC compared to the group without MC (median ΔNRS -5.0 vs -2.5, respectively, P = 0.043). In pairwise comparisons, a significant difference in ΔNRS was found between the MC1 group and the group without MC (median ΔNRS -5.0 vs -2.5, respectively, P = 0.012).
CONCLUSIONS
We propose that MC type 1 are associated with lumbar spinal pain, and that the pain arises at least partly from the adjacent IVD or endplate.
目的
评估椎间盘内骨块切除术后疼痛缓解程度与相邻 Modic 改变（MC）的存在和类型之间的相关性。
方法
我们回顾性分析了根据脊柱矫形医生的临床评估和磁共振成像（MRI）怀疑特定腰椎间盘（IVD）引起慢性下腰痛（LBP）的患者。因此，选择这些患者接受椎间盘内骨块切除。我们根据疼痛出现的腰椎节段，计算椎间盘内骨块切除术后疼痛缓解程度（ΔNRS），并分析 MRI 上 MC 的存在和类型。我们评估了 MC 缺失和存在组以及 MC 亚型组之间的 ΔNRS 差异。
结果
本研究共纳入 45 例患者，均在单一节段行椎间盘内骨块切除。总 MC 患病率为 77.8%（35 例）；单纯或主要 MC 1 型（MC1 组）占 35.6%（16 例）；单纯或主要 MC 2 型（MC2 组）占 42.2%（19 例）。与无 MC 组相比，MC 组的 ΔNRS 显著更大（中位数 ΔNRS 分别为-5.0 与-2.5，P=0.043）。在两两比较中，MC1 组与无 MC 组的 ΔNRS 差异有统计学意义（中位数 ΔNRS 分别为-5.0 与-2.5，P=0.012）。
结论
我们提出 MC 1 型与腰椎脊柱疼痛相关，并且疼痛至少部分来自相邻的 IVD 或终板。
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