中华骨科杂志
中華骨科雜誌
중화골과잡지
CHINESE JOURNAL OF ORTHOPAEDICS
2014年
5期
503-509
,共7页
乔攀%丁文元%张晓林%张雯
喬攀%丁文元%張曉林%張雯
교반%정문원%장효림%장문
颈椎%脊髓压迫症%椎间盘退行性变
頸椎%脊髓壓迫癥%椎間盤退行性變
경추%척수압박증%추간반퇴행성변
Cervical vertebrae%Spinal cord compression%Intervertebral disc degeneration
目的 探讨颈椎终板Modic改变在脊髓型颈椎病例中的临床分布特点,并探讨其发生的相关因素.方法 选择2012年1月至2013年6月期间,行颈椎正、侧位X线和颈椎矢状位、轴位MR检查并确诊为脊髓型颈椎病患者共426例,回顾性分析颈椎矢状位及轴位MRI中存在Modic改变在人群、年龄、病程、椎间盘节段、颈椎曲度和椎间盘退变分级中的分布特点和其发生的相关因素.结果 426例共2556个颈椎椎间盘中54例(12.7％)69个椎间盘117个终板(2.3％)发生Modic改变.Ⅰ型15例(3.5％),22个椎间盘42个终板(0.8％);Ⅱ型31例(7.3％),34个椎间盘61个终板(1.2％);Ⅲ型8例(1.9％),13个椎间盘14个终板(0.3％).按各个椎间盘节段发病数统计,C2-30个、C3-45个、C4-516个、C5-626个、C6-719个、C7T13个,发病率分别为0、0.2％、0.6％、1.0％、0.7％和0.1％.Modic改变和椎间盘退变明显相关.40岁以上患者是Modic 改变发生较多的年龄段.通过Binary Logistic检验逐步回归法得出回归方程为Y=-14.314+4.037D+0.784C+0.310L+0.203T+0.162A(Y为Modic改变、A为年龄、T为病程、L为椎间盘节段、D为椎间盘退变程度、C为Cobb角分组),P=0.001,EXP值:D=23.038,C=1.893,L=1.307,T=1.187,A=1.164.结论 脊髓型颈椎病终板Modic发生与椎间盘退变、椎间盘节段、病程、年龄和颈椎曲度存在相关性,椎间盘退变是最重要的影响因素.Modic改变中Ⅱ型最为多见,Ⅰ型次之,Ⅲ型最为少见,多发生于C5-6椎间盘,40岁以上多发.
目的 探討頸椎終闆Modic改變在脊髓型頸椎病例中的臨床分佈特點,併探討其髮生的相關因素.方法 選擇2012年1月至2013年6月期間,行頸椎正、側位X線和頸椎矢狀位、軸位MR檢查併確診為脊髓型頸椎病患者共426例,迴顧性分析頸椎矢狀位及軸位MRI中存在Modic改變在人群、年齡、病程、椎間盤節段、頸椎麯度和椎間盤退變分級中的分佈特點和其髮生的相關因素.結果 426例共2556箇頸椎椎間盤中54例(12.7％)69箇椎間盤117箇終闆(2.3％)髮生Modic改變.Ⅰ型15例(3.5％),22箇椎間盤42箇終闆(0.8％);Ⅱ型31例(7.3％),34箇椎間盤61箇終闆(1.2％);Ⅲ型8例(1.9％),13箇椎間盤14箇終闆(0.3％).按各箇椎間盤節段髮病數統計,C2-30箇、C3-45箇、C4-516箇、C5-626箇、C6-719箇、C7T13箇,髮病率分彆為0、0.2％、0.6％、1.0％、0.7％和0.1％.Modic改變和椎間盤退變明顯相關.40歲以上患者是Modic 改變髮生較多的年齡段.通過Binary Logistic檢驗逐步迴歸法得齣迴歸方程為Y=-14.314+4.037D+0.784C+0.310L+0.203T+0.162A(Y為Modic改變、A為年齡、T為病程、L為椎間盤節段、D為椎間盤退變程度、C為Cobb角分組),P=0.001,EXP值:D=23.038,C=1.893,L=1.307,T=1.187,A=1.164.結論 脊髓型頸椎病終闆Modic髮生與椎間盤退變、椎間盤節段、病程、年齡和頸椎麯度存在相關性,椎間盤退變是最重要的影響因素.Modic改變中Ⅱ型最為多見,Ⅰ型次之,Ⅲ型最為少見,多髮生于C5-6椎間盤,40歲以上多髮.
목적 탐토경추종판Modic개변재척수형경추병례중적림상분포특점,병탐토기발생적상관인소.방법 선택2012년1월지2013년6월기간,행경추정、측위X선화경추시상위、축위MR검사병학진위척수형경추병환자공426례,회고성분석경추시상위급축위MRI중존재Modic개변재인군、년령、병정、추간반절단、경추곡도화추간반퇴변분급중적분포특점화기발생적상관인소.결과 426례공2556개경추추간반중54례(12.7％)69개추간반117개종판(2.3％)발생Modic개변.Ⅰ형15례(3.5％),22개추간반42개종판(0.8％);Ⅱ형31례(7.3％),34개추간반61개종판(1.2％);Ⅲ형8례(1.9％),13개추간반14개종판(0.3％).안각개추간반절단발병수통계,C2-30개、C3-45개、C4-516개、C5-626개、C6-719개、C7T13개,발병솔분별위0、0.2％、0.6％、1.0％、0.7％화0.1％.Modic개변화추간반퇴변명현상관.40세이상환자시Modic 개변발생교다적년령단.통과Binary Logistic검험축보회귀법득출회귀방정위Y=-14.314+4.037D+0.784C+0.310L+0.203T+0.162A(Y위Modic개변、A위년령、T위병정、L위추간반절단、D위추간반퇴변정도、C위Cobb각분조),P=0.001,EXP치:D=23.038,C=1.893,L=1.307,T=1.187,A=1.164.결론 척수형경추병종판Modic발생여추간반퇴변、추간반절단、병정、년령화경추곡도존재상관성,추간반퇴변시최중요적영향인소.Modic개변중Ⅱ형최위다견,Ⅰ형차지,Ⅲ형최위소견,다발생우C5-6추간반,40세이상다발.
Objective To evaluate the distribution of Modic changes of cervical endplate in patients with cervical spondylotic myelopathy and its related factors.Methods All of 426 patients with cervical spondylotic myelopathy were examined by MRI scan and X-ray.According to the criteria of Modic changes,the distribution feature of Modic changes in cervical endplate on age,course of disease,segment and grade of intervertebral disc degeneration were retrospectively analyzed.Results Among 2556 intervertebral discs in 426 cases of patients,54 (12.7 ％) patients and 69 (2.3 ％) intervertebral discs were involved with Modic changes.22 (0.8％) discs in 15 (3.5％) cases were type Ⅰ; 34(1.2％) discs in 31 (7.3％) cases were type Ⅱ ; 13 (0.3％) discs in 8 (1.9％) cases were type Ⅲ.There were 0 (0) lesion in C2-3 disc,5 (0.2％) in C3-4,16 (0.6％) in C4-5,26 (1.0％) in C 19 (0.7％)in C6-7 and 3 (0.1％) in C7T1.Modic changes were distributed mainly over the age of 40 and correlated with disc degeneration,disc level,condition of cervical curve,course of disease and ages,moreover,disc degeneration played the most important role in the occurrence of Modic changes.Conclusion Modic changes of cervical endplate mainly occur in C5-6,and type Ⅱ is the most and type Ⅲ is the least.Modic changes are distributed mainly over the age of 40 and correlated with disc degeneration,disc level condition of cervical curve,course of disease and ages,moreover,disc degeneration plays an important role in the occurrence of Modic changes.
