颈椎终板Modic改变在颈肩痛病例中的分布和相关因素分析

目的 探讨颈椎终板Modic改变在颈肩痛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2006年一年内因颈肩痛而在本院行颈椎MR和常规X线检查的患者共1023例,回顾性分析颈椎MR中所表现的Modic改变在人群、椎间盘节段、年龄、颈椎曲度和椎间盘退变分级中的分布特点以及其发生的相关因素.结果 1023例共计6138个颈椎椎间盘中90例(8.8％),108(1.8％)个椎间盘邻近终板发生Modic改变.I型32例(3.1％),34个椎间盘(0.6％);Ⅱ型55例(5.4％),71个椎问盘(1.2％)Ⅲ型3例(0.3％),3个椎间盘(0.06％).按照各个椎间盘节段发病数统计,C2-3 O个、C3-4 10个、C415 18个、C5-6 52个、C6-7 23个、C7 T1 5个,发病率分别为O％、0.2％、0.4％、1.0％、0.4％、0.1％.Modic改变和椎间盘退变明显相关(P=0.000).40岁以上是Modic改变发生较多的年龄段(P=0.000).通过Binary Logistic检验逐步回归法得出回归方程为y=一15.514+3.047D+0.684C+0.210L+0.152,4(y为Modic改变、A为年龄、L为椎问盘节段、D为椎间盘退变程度、C为Cobb角分组),P=0.000,EXP值,D=21.048,C=I.982,L=1.233,A=1.164.结论 颈椎终板Modic改变发生率较腰椎低,其发生和椎间盘退变、椎间盘节段、年龄和颈椎曲度之间存在相关性,椎问盘退变是最重要的影响因素.Ⅱ型最为多见,I型次之,Ⅲ型最为少见,多发生于C3-6椎间盘.40岁以上是Modie改变易发年龄.

The distribution of Modic changes of cervical endplate in patients suffered neck pain and its related factors

0bjective To evaluate the distribution of Modic changes of cervical endplate in patients suffered neck pain and its related factors.Methods 1023 cases of patients suffered from neck pain without any pathological lesions were examined by MRi scan and X-ray.According to the criteria of Modic changes,the feature of distribution of Modic changes of cervical endplate on age,segment and grade of intervertebral disc degeneration was analyzed retrospectively.Results Among 6138 intervertebral disc of 1023 cases of patients,90(8.8%)patients and 108(1.8%)intervertebral discs were involved with Modic changes.32(3.1%) cases and 34(0.6%)discs were type I;55(5.4%)cases and 71(1.2%)discs were typeⅡ;3(0.3%)cases and 3(0.06%)discs were typeⅢ.According to the segment,the lesions involved C2-3. disc for 0(0%),C3-4 for 10(0.2%),C4-5 for 18(0.4%),C5-6 for 52(1.O%),C6-7 for 23(0.4%),C7-T1 for 5(0.1%).Modic changes was distributed mainly over the age of 40 and correlated with disc degeneration,disc level,condition of eervical curve and ages,moreover,disc degeneration played the most important role in the occurrence of Modic changes.Conclusion Modic changes of cervical endplate mainly OCCULT in C5-6 segment,then the C4-5 and C6-7 segment,and type Ⅱ is the most and type Ⅲ is the least.Modic changes is distributed mainlv over the age of 40 and correlated with disc degeneration,disc level condition of eervieal curve and ages,moreover,disc degeneration plays an important role in the occurrence of Modic changes.