退行性胸腰椎/腰椎后凸椎体终板Modic改变与脊柱骨盆矢状位参数相关性分析

目的探讨退行性胸腰椎/腰椎后凸椎体终板Modic改变(Thoracolumbar degenerative kyphosis/Lumbar degenerative kyphosis,TLDK/LDK)与脊柱骨盆矢状位参数的相关性。方法回顾性分析自2016-03—2018-03诊治的116例TLDK/LDK,记录T₁₀至S₁椎体出现Moidc改变的情况,并测量矢状位全脊柱X线片下脊柱-骨盆参数,分析Modic改变终板数量与矢状面偏移(Sagittal vertical axis,SVA)、胸椎后凸角(Thoracic kyphosis,TK)、胸腰后凸角(Thoracolumbar kyphosis,TLK)、腰椎前凸角(Lumbar lordosis,LL)、骨盆入射角(Pelvis incidence,PI)、骶骨倾斜角(Sacral slope,SS)、骨盆倾斜角(Pelvic tilt,PT)的相关性。结果 116例共1856个椎体终板均顺利完成检查,共62例184个椎体终板出现Modic改变,6例共12个椎体终板出现Ⅰ型改变,50例共137个椎体终板出现Ⅱ型改变,36例共35个椎体终板出现Ⅲ型改变。相关性分析结果显示出现椎体Modic改变的终板数量与LL、SS呈负相关,与PT成正相关(P<0.05)。结论 TLDK/LDK的Modic改变以Ⅱ型多见,Modic改变与LL、SS、PT存在相关性。

Correlation between Modic changes and sagittal spinal-pelvic parameters in thoracolumbar/lumbar degenerative kyphosis patients

Objective To investigate the correlation between the Modic changes of the vertebral endplate and sagittal spinalpelvic parameters in thoracolumbar degenerative kyphosis/lumbar degenerative kyphosis(TLDK/LDK) patients.MethodsOne hundred and sixteen cases of TLDK/LDK diagnosed and treated from March 2016 to March 2018 were retrospectively analyzed.The Modic changes at the vertebral endplate from T₁₀ to S₁ were recorded. The sagittal spinal-pelvic parameters were measured using the whole spine plain radiograph. The correlations between the number of vertebral endplate with Modic changes and sagittal vertical axis(SVA), thoracic kyphosis(TK), thoracolumbar kyphosis(TLK), lumbar lordosis(LL), pelvis incidence(PI),sacral slope(SS), pelvic tilt(PT) were analyzed.ResultsOne hundred and sixteen patients were successfully examined. Of the1856 intervertebral endplates from 116 patients, Modic changes occurred at 184 endplates of 62 patients. Twelve endplates of 6 patients were classified as type Ⅰ, 137 endplates of 50 patients as type Ⅱ, 35 endplates of 36 patients as type Ⅲ. Correlation analysis showed that the number of vertebral endplates with Modic changes was negatively correlated to LL and SS, and positively correlated to PT(P<0.05).ConclusionMost of the Modic changes of vertebral endplates in TLDK/LDK patients are typeⅡ. The Modic changes of vertebral endplates are found to be significantly correlated with LL, SS, and PT.