腰椎Modic I、Ⅱ型面积改变率与TNF-α相关性研究

目的：探讨腰椎Modic I、Ⅱ型面积改变率与对应终板中TNF-α含量的相关性。方法52例因下腰痛手术患者（男29例，女23例），平均年龄（51.0±11.89）岁。术前行MRI检查，其中无Modic改变型16例，Modic I型15例，ModicⅡ型21例。测量3组在MRI T2正中矢状位上Modic改变面积及对应椎体面积大小，计算Modic改变率。术中收集椎间盘髓核、椎体终板部分组织作TNF-α免疫组化染色，观察其在髓核和终板组织中的差异，统计与终板面积改变率的相关性。结果无Modic改变型：髓核和终板组织中TNF-α染色极少，Modic I型组：TNF-ɑ在终板的表达明显高于髓核，与面积变化率的相关系数r=0.431，P=0.021，两者具有正相关性。ModicⅡ型组：TNF-ɑ在终板的表达与髓核组织相似，与面积变化率的相关系数r=0.322，P=0.043，两者具有正相关性。结论下腰痛患者中Modic I、Ⅱ型面积改变率与所对应终板中TNF-ɑ炎性因子含量密切相关。

Correlation of TNF-ɑ expression with Modic changes in vertebral endplates of patients with low back pain

Objective To investigate the correlation of TNF- ɑ expression with Modic changes in vertebral endplates of patients with low back pain. Methods Seventy patients （29 males and 23 females） with an average age of 51.0±11.89 under-going low back pain surgery were examined with MRI. Among them, 16 cases had no Modic changes,15 cases were Modic I and 21cases were Modic II. The Modic changes at sagittal plane on MRI T2 and the area of corresponding vertebral were measured. The samples of intervertebral disc endplates and nucleus pulposus were col ected and the expression of TNF- ɑ was detected with immunohistochemistry. Results TNF- ɑwas scarcely expressed in the non- Modic type. In Modic type I, the expression of TNF- ɑin endplate was higher than that in nucleus and the expression of TNF- ɑwas positively correlated with the area change rate （r=0.431, P=0.021）. In Modic type II there was no difference in TNF- ɑexpressions between endplate and nucleus, and the correlation coefficient between TNF- ɑexpression and area change rate was 0.322 （P=0.043）. Conclusion The TNF- ɑlevel in endplates was correlated with the change area rate of Modic I and II in low back pain patients.