Department of Orthopedics and Traumatology, The University of Hong Kong, Hong Kong SAR, China.
Spine (Phila Pa 1976). 2023 Jun 15;48(12):E177-E187. doi: 10.1097/BRS.0000000000004632. Epub 2023 Mar 22.
Prospective observational study.
To determine the prevalence of isolated thoracic degeneration on magnetic resonance imaging (MRI), demographic factors and imaging features, as well as the patient-reported quality of life outcomes associated with this condition.
Thoracic intervertebral discs are least susceptible to disc degeneration (DD) and may represent a manifestation of "dysgeneration." These discs may never be hydrated from the beginning and seem hypointense on MRI.
A population-based MRI study of 2007 volunteers was conducted. Each disc from C2/3 to L5/S1 was measured by Pfirrmann and Schneiderman grading. Disc herniation, Schmorl node (SN), high-intensity zones (HIZ), and Modic changes were studied. DD was defined by Pfirrmann 4 or 5. patient-reported quality of life scores, including a 36-item short-form questionnaire and visual analog scale for low back pain, were recorded. Subjects were divided into "isolated thoracic degeneration" (only thoracic segment) and "tandem thoracic degeneration" (thoracic with other segments). The association between imaging findings and isolated thoracic degeneration was determined using multivariate logistic regression.
The mean age of the subjects was 50.0 ± 0.5 and 61.4% were females (n = 1232). Isolated thoracic degeneration was identified in 2.3% of the cohort. Factors associated with isolated thoracic degeneration included lower age, C6/7 HIZ, T8/9 HIZ, and T8/9 SN. Factors associated with tandem thoracic degeneration included L4/5 posterior bulging. The thoracic and lumbar tandem degeneration group demonstrated higher bodily pain, despite a lower visual analog scale, and a higher physical component score of the 36-item short form.
Isolated thoracic degeneration demonstrated an earlier age of onset, mostly involving the mid-thoracic region (T5/6-T8/9), and in association with findings such as SN. Subjects with tandem thoracolumbar degeneration had less severe lumbar DD and low back pain as compared with those with isolated lumbar degeneration. This paints the picture of "dysgeneration" occurring in the thoracic and lumbar spine.
前瞻性观察研究。
确定磁共振成像（MRI）上孤立性胸段退变的流行率、人口统计学因素和影像学特征，以及与这种情况相关的患者报告的生活质量结果。
胸椎间盘最不易发生椎间盘退变（DD），可能代表“退变”的一种表现。这些椎间盘可能从一开始就从未被水合，在 MRI 上似乎呈低信号。
对 2007 名志愿者进行了一项基于人群的 MRI 研究。通过 Pfirrmann 和 Schneiderman 分级对 C2/3 至 L5/S1 的每个椎间盘进行测量。研究了椎间盘突出、Schmorl 结节（SN）、高信号区（HIZ）和 Modic 改变。DD 定义为 Pfirrmann 4 或 5 级。记录了患者报告的生活质量评分，包括 36 项简短调查问卷和下腰痛视觉模拟量表。将受试者分为“孤立性胸段退变”（仅胸段）和“串联胸段退变”（胸段伴其他节段）。使用多变量逻辑回归确定影像学发现与孤立性胸段退变的关系。
受试者的平均年龄为 50.0 ± 0.5 岁，61.4%为女性（n = 1232）。队列中有 2.3%的人被诊断为孤立性胸段退变。与孤立性胸段退变相关的因素包括年龄较小、C6/7 HIZ、T8/9 HIZ 和 T8/9 SN。与串联胸腰椎退变相关的因素包括 L4/5 后膨出。尽管视觉模拟量表较低，但胸腰椎串联退变组的躯体疼痛较高，36 项简短形式的物理成分评分也较高。
孤立性胸段退变的发病年龄较早，主要累及中胸段（T5/6-T8/9），并与 SN 等发现相关。与孤立性腰椎退变相比，串联胸腰椎退变的患者腰椎 DD 程度较轻，腰痛较轻。这描绘了胸腰椎发生“退变”的情况。
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Zotero 插件
