Twenty-year Longitudinal Follow-up MRI Study of Asymptomatic Volunteers: The Impact of Cervical Alignment on Disk Degeneration
Twenty-year Longitudinal Follow-up MRI Study of Asymptomatic Volunteers: The Impact of Cervical Alignment on Disk Degeneration
复制标题
无症状志愿者二十年纵向随访 MRI 研究：颈椎排列对椎间盘退变的影响
DOI：
10.1097/bsd.0000000000000706
复制
发表时间：
2018
影响因子：
1.9
通讯作者：
Kota Watanabe
中科院分区：
文献类型：
--
作者：
Eijiro Okada;Kenshi Daimon;H. Fujiwara;Y. Nishiwaki;K. Nojiri;Masahiko Watanabe;H. Katoh;K. Shimizu;Hiroko Ishihama;Nobuyuki Fujita;T. Tsuji;M. Nakamura;M. Matsumoto;Kota Watanabe
研究设计：一项20年的纵向研究。目的：评价颈椎矢状位对准对无症状健康人椎间盘退变的远期疗效。背景资料总结：本研究延续了之前10年的纵向研究，以确定矢状面排列是否影响正常衰老过程中的椎间盘退变。材料和方法：我们评估了1994年至1996年间接受颈椎磁共振成像（MRI）和x线平片检查的497名志愿者中的90名健康受试者（30名男性和60名女性）（随访率为18.1%）。初始研究时的平均年龄为35.5±13.4岁（11-65岁）。我们比较了初始mri和随访mri，在初始研究后平均21.6年进行，发现(1)椎间盘信号强度降低，(2)后椎间盘突出，(3)椎间盘空间从C2-3缩小到C7-T1。受试者按随访时的年龄（40岁以下vs. 40岁及以上）和基线时颈椎前凸或非前凸矢状位排列进行分组。我们在随访中评估了颈部疼痛、肩部僵硬和上臂麻木，并检查了临床症状与MRI参数之间的关系。结果：20年间的进行性变化包括椎间盘信号强度下降（84.4%）、后椎间盘突出（86.7%）和椎间盘空间变窄（17.8%）。矢状面排列与椎间盘信号强度降低、后椎间盘突出或椎间盘间隙狭窄之间无显著关联。在40岁以上的受试者中，C7-T1时进行性退行性改变在无颈椎前凸的受试者中（90.9%）明显高于颈椎前凸的受试者（54.2%，P=0.032）。在随访中，前凸和非前凸受试者的临床症状患病率相似。结论：非前凸性颈椎直线与C7-T1椎间盘退变的进展有关，而与其他水平无关。在健康受试者中，颈椎对位不影响临床症状的发展。证据等级：三级。
Study Design: A 20-year longitudinal study. Objective: To evaluate the long-term effect of sagittal alignment of the cervical spine on intervertebral disk degeneration in healthy asymptomatic subjects. Summary of Background Data: This study continues a previous 10-year longitudinal study to determine whether sagittal alignment affects disk degeneration during normal aging. Materials and Methods: We assessed 90 healthy subjects (30 men and 60 women) from among 497 volunteers who underwent magnetic resonance imaging (MRI) and plain radiographs of the cervical spine between 1994 and 1996 (follow-up rate 18.1%). The mean age at the initial study was 35.5±13.4 years (11–65 y). We compared initial MRIs and follow-up MRIs, conducted at an average of 21.6 years after the initial study, for (1) decreased signal intensity of the intervertebral disks, (2) posterior disk protrusion, and (3) disk-space narrowing from C2–3 to C7–T1. Subjects were grouped by age at follow-up (under 40 vs. 40 y and older) and by a lordotic or nonlordotic cervical sagittal alignment at baseline. We assessed neck pain, stiff shoulders, and upper-arm numbness at follow-up, and examined associations between clinical symptoms and MRI parameters. Results: Progressive changes during the 20-year period included a decrease in disk signal intensity (84.4% of subjects), posterior disk protrusion (86.7%), and disk-space narrowing (17.8%). No significant association was observed between sagittal alignment and decreased disk signal intensity, posterior disk protrusion, or disk-space narrowing. Among subjects over the age of 40, progressive degenerative changes at C7–T1 were significantly more frequent in nonlordotic subjects (90.9%) compared with those with cervical lordosis (54.2%, P=0.032). The prevalence of clinical symptoms was similar in lordotic and nonlordotic subjects at follow-up. Conclusions: Nonlordotic cervical alignment was related to the progression of disk degeneration at C7–T1 but not other levels. Cervical alignment did not affect the development of clinical symptoms in healthy subjects. Level of Evidence: Level III.
影响因子：
9.8
作者：
Mio, Futoshi;Chiba, Kazuhiro;Ikegawa, Shiro
通讯作者：
Ikegawa, Shiro