颈椎终板Modic改变分布特点与退变的关系

背景：关于Modic改变在腰椎中分布及特点的相关性研究比较多，而在颈椎中的相关研究则较少。目的：分析颈椎终板Modic改变的临床分布特点，并探讨其发生与颈椎退变的相关性。方法：随机抽取因颈肩痛行颈椎MRl和常规X射线榆查的患者共200例，年龄20-83岁。记录MRl颈椎Modic改变发生的节段，改变类型，改变的位置等，并分析其发生与性别、年龄、椎间盘退变节段及程度、椎间隙高度、颈椎曲度的相关性。结果与结论：200例共计1200个颈椎椎间盘中23例（11.5％），29个（2.4％）个椎间盘邻近终板发生Modic改变。I型8例（4％），10个椎间盘（0.8％）；II型13例（6.5％），16个椎间盘（113％）；III型2例（1.0％），3个椎间盘（O.25％）。按照各个椎间盘节段发病数统计，C2/3节段O个，C3/4节段4个，C4／5节段6个，C5/6节段12个，C6/7节段7个，C6/7T1节段0个，发病率分别为O％，0.33％，O.5％，1.0％，O.58％，0％。结果表明颈椎终板也存在Modic改变的现象，但发生率较腰椎低，II型最多见，I型次之，III型最为少见，多发生于C5/6椎间盘，多位于邻近终板的后方。50岁以上为其好发年龄，其发生与年龄、椎间盘退变、椎间盘节段及颈椎曲度之间存在相关性。

Characteristics of Modic changes in the cervical spine and its relationship with cervical degeneration

BACKGROUND： The distribution and characteristics of Modic changes in lumbar spine have been described, but there are few studies focusing on Modic changes in the cervical spine OBJECTIVE： To report on the prevalence, types, distribution of Modic changes and its relationship with cervical degeneration found in the cervical spine. METHODS： From 1 187 cases in the year 2009, 200 patients aged 20-83 years, randomly selected cervical spine MRI and X-ray were viewed. Data were recorded for patient age, patient sex, and the presence or absence of Modic changes, then the specific Modic type and the precise vertebral levels and location of these changes were recorded. The prevalence of Modic changes on sex, age, segment, grade of intervertebral disc degeneration, disc height and cervical curve was analyzed retrospectively. RESULTS AND CONCLUSION： Among 1 200 intervertebral discs of 200 patients, 23（11.5%） patients with 29（2.4%） intervertebral discs were involved with Modic changes. Eight（4%） cases with 10 （0.8%） discs were diagnosed as type I; 13 （6.5%） cases with 16（1.3%） discs were type II ; 2 （1%） cases with 3 （0.25%） discs were type I｜]. According to the segment, the lesions involved 0213 for 0 （0%）, 03/4 for 4 （0.33%）, C4/5 for 6 （0.5%）, C5/6 for 12 （1%）, O6/7 for 7 （0.58%）, C7/T1 for 0 （0%）. These findings demonstrated that Modic changes are observed in the cervical spine, with the C5/6 level being the most commonly involved. Like in the lumbar spine in which Modic type II changes predominate, type II is the most, type III is the least. They are far more common in the posterior area of the endplate. Modic changes are distributed mainly over the age of 50, which are correlated with ages, grade of disc degeneration, disc level, disc height and cervical curve.