Motion characteristics and related factors of Modic changes in the lumbar spine
Motion characteristics and related factors of Modic changes in the lumbar spine
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DOI：
10.3171/2014.10.spine14496
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发表时间：
2015-05-01
影响因子：
2.8
通讯作者：
Wang, Jeffrey C.
中科院分区：
文献类型：
--
作者：
Hayashi, Tetsuo;Daubs, Michael D.;Wang, Jeffrey C.
目的：大多数关于Modic改变（MCs）的研究都集中在MCs与下腰痛之间的关系，而与MCs相关的运动学特征和退行性椎间盘疾病还没有得到很好的理解。据作者所知，以前没有研究报告的运动学MC。本研究的目的是阐明MC节段运动和退行性disc diseases.METHODS四百五十症状患者进行负重腰椎运动MRI在中立，屈曲，伸展位置的关系。用计算机分析软件测量3个位置的节段位移和椎间角度。记录Modic改变、椎间盘退变、椎间盘膨出、脊椎前移、角运动和平移运动，并使用逻辑回归模型分析MC与这些因素的关系。为了控制椎间盘退变对节段运动的影响，根据轻度和重度椎间盘退变阶段分析角度和平移运动。结果多因素分析显示，年龄、椎间盘退变、角运动、平移运动是影响MCs的显著因素。在严重的椎间盘退变阶段，角运动的显着减少和平移运动的显着增加被发现在节段与MC，表明终板的障碍有一个额外的影响节段的运动。随着MC类型的增加，椎间盘退变逐渐增加，角运动逐渐减少。平移运动显着增加与2型MCs.CONCLUSIONS年龄，椎间盘退变，角运动，平移运动显着链接到MCs在腰椎。腰椎节段的平移运动随着2型MC的增加而增加，而角运动随着MC类型的增加而减少，表明2型MC可能由于退行性变化而具有平移不稳定性。终板紊乱在脊柱不稳定中起重要作用。
OBJECT Most studies of Modic changes (MCs) have focused on investigating the relationship between MCs and low-back pain, whereas the kinematic characteristics and degenerative disc disease associated with MCs are not well understood. To the authors' knowledge, no previous study has reported on the kinematics of MCs. The purpose of this study was to elucidate the relationship of MCs to segmental motion and degenerative disc disease.METHODS Four hundred fifty symptomatic patients underwent weight-bearing lumbar kinematic MRI in the neutral, flexion, and extension positions. Segmental displacement and intervertebral angles were measured in 3 positions using computer analysis software. Modic changes, disc degeneration, disc bulging, spondylolisthesis, angular motion, and translational motion were recorded, and the relationship of MCs to these factors was analyzed using a logistic regression model. To control the influence of disc degeneration on segmental motion, angular and translational motion were analyzed according to mild and severe disc degeneration stages. The motion characteristics and disc degeneration among types of MCs were also evaluated.RESULTS Multivariate analysis revealed that age, disc degeneration, angular motion, and translational motion were factors significantly related to MCs. In the severe disc degeneration stage, a significant decrease of angular motion and significant increase of translational motion were found in segments with MCs, indicating that a disorder of the endplate had an additional effect on segmental motion. Disc degeneration increased and angular motion decreased significantly and gradually as the type of MC increased. Translational motion was significantly increased with Type 2 MCs.CONCLUSIONS Age, disc degeneration, angular motion, and translational motion were significantly linked to MCs in the lumbar spine. The translational motion of lumbar segments increased with Type 2 MCs, whereas angular motion decreased as the type of MC increased, indicating that Type 2 MCs may have translational instability likely due to degenerative changes. A disorder of the endplates could play an important role in spinal instability.