CAJ | 학술논문

目的:探讨MRI上Modic改变与腰痛(low back pain,LBP)的相关性.方法:通过检索MEDLINE、EMBASE和Cochrane Controlled Clinical Trials Register等电子数据库,搜集符合要求的关于Modic改变的临床研究.提取的主要数据为(1)椎间盘造影术后发生疼痛(与原腰痛症状相似)的椎间盘数和其中发生Modic改变的椎间盘数;(2)椎间盘造影术后未发生疼痛(无腰痛和未发生与原腰痛症状相似的疼痛)的椎间盘数和其中发生Modic改变椎间盘数.将其带入Meta分析软件Review Manager 4.2(下载自Cochrane Libirary)中,在随机效应模型(Random-efiect model)下,用优势比(odds ratio,OR)计算结果,并进行敏感性分析.然后对Modic 改变的不同亚型进行对比分析.结果:经筛选,共6篇文献纳入Meta分析.6篇文献共纳入患者966例,椎间盘3026个.椎间盘造影术后疼痛组和无疼痛组相比,OR值为3.66(95%CI,1.46～9.15).椎间盘造影术后疼痛组1型Modic改变与2型Modic改变相比,OR值为1.31(95%CI,0.35～4.96).结论:和无腰痛患者相比,腰痛患者的Modic改变发生率更高;与2型Modie改变相比,尚没有证据表明1型Modic改变更易引起腰痛.
목적:탐토MRI상Modic개변여요통(low back pain,LBP)적상관성.방법:통과검색MEDLINE、EMBASE화Cochrane Controlled Clinical Trials Register등전자수거고,수집부합요구적관우Modic개변적림상연구.제취적주요수거위(1)추간반조영술후발생동통(여원요통증상상사)적추간반수화기중발생Modic개변적추간반수;(2)추간반조영술후미발생동통(무요통화미발생여원요통증상상사적동통)적추간반수화기중발생Modic개변추간반수.장기대입Meta분석연건Review Manager 4.2(하재자Cochrane Libirary)중,재수궤효응모형(Random-efiect model)하,용우세비(odds ratio,OR)계산결과,병진행민감성분석.연후대Modic 개변적불동아형진행대비분석.결과:경사선,공6편문헌납입Meta분석.6편문헌공납입환자966례,추간반3026개.추간반조영술후동통조화무동통조상비,OR치위3.66(95%CI,1.46～9.15).추간반조영술후동통조1형Modic개변여2형Modic개변상비,OR치위1.31(95%CI,0.35～4.96).결론:화무요통환자상비,요통환자적Modic개변발생솔경고;여2형Modie개변상비,상몰유증거표명1형Modic개변경역인기요통.
Objective:To determine the relationship between Modic changes and low back pain(LBP) through Meta-analysis.Method:MEDLINE,EMBASE and Cochrane Controlled Clinical Trials Register databases were carefully searched to determine relevant papers.The parameter index for Meta-analysis included the number of symptomatic lumbar discs which pain can be provoked by discography or not (with pain similar to the primary) as well as the number with Modic changes among them.The results were brought to Review Manager 4.2 (download from Cochrane Library) and measured using odds ratio (OR) under Random-effect model for sensitivity analysis.Further comparative analysis between the subgroups was performed thereafter.Result: After screening out,a total of 6 papers were meet our inclusion criterion for Meta-analysis.There were 966 cases and 3026 discs/The combined OR value for pain group and painless group after discography was 3.66(95% CI, 1.46-9.15).While the combined OR value for type 1 and type 2 Modic change in pain group after discography was 1.31 (95%CI,0.35-4.96).Conclusion:There is higher incidence rate of Modic changes in LBP patients compared with those in no LBP patients.No evidence available supports type 1 Modic changes is more relevant to low back pain.