软骨终板形态与椎间盘退变的相关性

背景：以往研究证明多种内环境因素共同作用引发椎间盘退变,最重要的机制为椎间盘软骨终板的退变。目的：分析椎间盘退变与终板形态的关系。方法：回顾性分析62例因椎间盘源性慢性下腰痛和79例因髓核脱出致神经根性症状患者的腰椎MRI正中矢状位图像资料。根据腰椎MRI正中矢状位T1W1图像确定终板形态,T2W1图像确定椎间盘退变程度分级。结果与结论：平坦型和不规则型终板最常见于椎间盘退变人群下腰椎,L5/S1平坦型最多见。髓核脱出组与椎间盘源性慢性下腰痛组中凹陷型终板椎间盘退变程度均较平坦型、不规则型低,平坦型终板椎间盘退变程度较不规则型低(P < 0.01)。两组间凹陷型与不规则型终板椎间盘退变程度差异无显著性意义,髓核脱出组平坦型椎间盘退变程度较椎间盘源性慢性下腰痛组高(P < 0.05)。提示随着椎间盘退变程度的加重,软骨终板形态有由凹陷型向平坦型、不规则型依次转变的趋势。

Correlation between vertebral endplate shape and intervertebral disc degeneration

BACKGROUND:Previous studies have shown that a variety of environmental factors lead to disc degeneration, and the most important mechanism is the degeneration of the cartilage endplate.OBJECTIVE:To analyze the relationship between intervertebral disc degeneration and endplate shape.METHODS:A retrospective analysis of sagittal MRI was performed in 62 patients with discogenic chronic low back pain and 79 patients with radicular symptoms because of herniated nucleus pulposus. The endplate shape was determined according to sagittal T1-weighted MRI, and the disc degeneration was graded on T2-weighted sequences.RESULTS AND CONCLUSION:Flat and irregular endplates were most common in the lower lumbar spine of people who had disc degeneration. Flat endplate at L5/S1 segment was the most common. In the two groups, disc degeneration degree of concave endplates was lower than those of flat or irregular endplates, and the degree of flat endplate was lower compared with irregular endplate (P < 0.01). The differences in disc degeneration degree of concave and irregular endplates between the two groups had no significance, while disc degeneration degree of flat endplate in the herniated nucleus pulposus group was higher compared with the discogenic chronic low back pain group (P < 0.05). It is indicated that with the severity of disc degeneration, the endplate will gradually change from concavetype shape to flat shape and irregular shape.