腰椎滑脱椎体终板Modic改变的分布情况及影响因素

目的探讨腰椎滑脱椎体终板Modic改变的分布情况，分析峡部裂性滑脱与退变性滑脱终板Modic改变相关影响因素。方法回顾性分析2005年10月～2011年10月收治的264例腰椎滑脱症患者的影像学资料。比较不同类型腰椎滑脱Modic改变的类型，分析不同类型腰椎滑脱中Modic改变与腰椎滑脱程度、椎间盘退变、体重指数、劳动量的相关性。结果退变性滑脱113例，其中ModicI型7例（6．2％），ModicⅡ型38例（33．6％）；峡部断裂性滑脱151例，其中ModicI型12例（7．9％），Modic1I型23例（15．2％），Modicm型28例（18．5％）。腰椎滑脱伴Modic改变的患者中，滑脱节段Modic改变发生率显著高于非滑脱节段。不同类型腰椎滑脱中Modic改变与滑脱程度、椎间盘退变、体重指数、劳动量存在明显相关性（P〈0．05）。结论腰椎滑脱中Modie改变与滑脱程度、椎间盘退变、体重指数、劳动量存在相关性；Modic改变在退变性滑脱中Ⅱ型较多，在峡部裂性滑脱中以Ⅲ型多见，并且Modic改变易发生在滑脱节段。

Distribution of Modic changes of endplate in lumber spondylolisthesis and its ralted factors

Objective To evaluate the distribution of Modic changes of endplate in lumber spondylolisthesis and its ralted factors.Methods The imaging data of 264 patients with lumber spondylolisthesis treated in our hospital from October 2005 to October 2011 were reviewed retrospectively.The incidence and the type of Modic changes was compared between isthmic spondylolisthesis and degenerative spondylolisthesis.The correlation between Modic changes and slipping degree of spondylolisthesis,disc degenerations,body mass index and physical activity were analyzed.Results Of all patients,113 patients diagnosed to be degenerative spondylolisthesis,7 patients(6.2%)were classified as type Ⅰ and 38 patients(33.6%) as type Ⅱ;and 151 patients diagnosed to be isthmic spondylolisthesis,12 patients(7.9%)were classified as type Ⅰ,23 patients(15.2%) as type Ⅱ,and 28 patients(18.5%)were classified as type Ⅲ.In the patients with lumber spondylolisthesis and Modic changes,the incidence rate of the Modic changes in the level of spondylolysis was more higher than the ones in the rest levels.Modic changes were significantly correlated with slipping degree of spondylolisthesis,disc degenerations,body mass index and physical activity(P<0.05).Conclusion Modic changes correlate with slipping degree of spondylolisthesis,disc degenerations,body mass index and physical activity.In the isthmic spondylolisthesis,the most of Modic changes are type Ⅱ;and in the degenerative spondylolisthesis,Modic type Ⅲ changes predominate,and most of Modic change locate on the level of spondylolysis.