| 摘要: |
| 目的:探讨颈椎病患者椎体终板Modic改变的发病情况及临床价值。方法:回顾分析136例颈椎病患者的颈椎MRI矢状位图像资料,记录椎体终板Modic改变的发生率、类型、各节段分布及各分布节段类型,统计并分析Modic改变与颈部轴性疼痛的关系。结果:136例颈椎病患者中有23例存在Modic改变,发生率为16.9%；男性患者中发生率为17.7%,女性为15%；最常出现Modic改变的节段为C5/6；Modic Ⅰ型、Ⅱ型和Ⅲ型的发生率分别为4.4%、7.4%、5.1%。存在Modic改变的患者中,轴性疼痛发生率为56.5%,术后缓解率为76.9%；无Modic改变者轴性疼痛的发生率为20.4%,术后缓解率为73.9%,两者轴性疼痛发生率有显著性差异(P<0.05),术后缓解率无统计学差异(P>0.05)。Modic改变Ⅰ、Ⅱ、Ⅲ型患者中轴性疼痛发生率分别为83.3%、60%和28.6%,术后缓解率分别为100%、66.7%和50%；Modic改变Ⅰ型患者轴性疼痛发生率和术后缓解率均较其他两型为高(P<0.05)。结论:颈椎病患者中Modic改变以Ⅱ型最多,以C5/6节段最为常见。Modic改变患者轴性疼痛发生率较高,其中以Modic Ⅰ型为著。 |
| 关键词: Modic改变 轴性疼痛 颈椎 终板 |
| DOI：10.3724/SP.J.1008.2008.00 |
| 投稿时间：2008-03-19修订日期：2008-06-09 |
| 基金项目: |
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| Relationship of Modic changes in endplates of cervical vertebral body with axial pain |
| WANG Xin-wei*, TANG Jun-jun, YUAN Wen, GU Tao, HAN Zhu, ZHANG Ying, LIN Qiu-shui |
| (Department of Orthopedics, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China) |
| Abstract: |
| Objective:To investigate the prevalence and clinical significance of Modic changes in endplates of cervical vertebral body in patients with cervical spondylotic myelopathy(CSM).Methods: The T1-weight and T2-weight sagittal MRI scans of 136 CSM patients undergoing anterior operation were retrospectively reviewed. The patients’ age, gender, prevalence, precise vertebral levels and specific type of Modic changes were recorded, and the association of axial pain with Modic changes was analyzed.Results: Modic changes were observed in 23 patients (16.9%), including 17(17.7%) male and 6(15%) female. The most frequent cervical spinal levels of Modic changes was C5-6. Of all the patients, 4.4％ had type Ⅰ Modic change, 7.4％ had type Ⅱ, and 5.1％ had type Ⅲ. The incidence of axial pain was 56.5% in Modic change groups and 20.4% in non-Modic change groups; there was significant difference between the two groups (P<0.05). Postoperatively, the axial pain was relieved in 76.9% in Modic change groups and 73.9% in non-Modic change groups (P>0.05). The pre-operation incidences of axial pain in patients with type Ⅰ, type Ⅱ and type Ⅲ Modic change were 83.3％, 60％ and 28.6%, respectively; and the post-operation pain-relieving rates were 100％, 66.7％ and 50％, respectively.Conclusion: The most common Modic change is type Ⅱ in the cervical spine, with the C5-6 level being the most frequently involved. The incidence of axial pain is high in patients with Modic change, especially those with type Ⅰ. |
| Key words: Modic changes axial pain cervical spine MRI vertebral endplate |
