Association between modic changes, disc degeneration, and pelvic incidence-lumbar lordosis mismatch in a large population based cohort: the Wakayama spine study.
Association between modic changes, disc degeneration, and pelvic incidence-lumbar lordosis mismatch in a large population based cohort: the Wakayama spine study.
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在基于大量人群的队列中，现代变化、椎间盘退变和骨盆入射角-腰椎前凸不匹配之间的关联：和歌山脊柱研究。
DOI：
10.1007/s00586-023-07702-8
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发表时间：
2023
期刊：
影响因子：
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通讯作者：
Yamada H.
中科院分区：
文献类型：
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作者：
Teraguchi M;Hashizume H;Asai Y;Oka H;Nagata K;Ishimoto Y;Iwasaki H;Tsutsui S;Takami M;Tanaka S;Yoshida M;Yoshimura N;Yamada H.
目的脊柱平面对线是治疗脊柱对线不良和腰痛的关键。骨盆倾斜-腰椎前凸（PI-LL）不匹配常用于评价矢状面对线不良患者的临床结局。PI-LL不匹配和椎间盘周围变化之间的关联对于理解所涉及的代偿机制非常重要。本研究旨在探讨PI-LL不匹配和磁共振成像（MRI）周围的椎间盘在一个大的人口为基础的cohol.MethodsWe的变化之间的关联评估参与者从第二个和歌山脊柱研究，招募一般人群年龄在20岁或以上，不分性别，谁是在2014年在一个地区的注册居民。总共有857名患者接受了全脊柱MRI检查;然而，由于图像不完整或质量不足，43名患者的MRI结果未被纳入。PI-LL不匹配定义为> 11°。我们比较了PI-LL错配组和非PI-LL错配组的MRI改变，如Modic改变（MC）、椎间盘退变（DD）和高信号区（HIZ）。进行多变量logistic回归分析，以确定调整年龄，性别和身体质量指数在腰椎区域和在每个level.ResultsA共795名参与者（243名男性，552名女性，平均年龄63.5 ± 13.1岁）的MRI变化和PI-LL不匹配之间的关联进行了评估; 181被列入PI-LL不匹配组。PI-LL不匹配组腰椎区域的MC和DD显著较高。腰部MC与PI-LL不匹配显着相关（比值比（OR）; 1.81，95%置信区间（CI）1.2-2.7）。每个节段的MC与PI-LL错配显著相关（OR; 1.7-1.9，95%CI 1.1-3.2），L1/2、L3/4和L4/5的DD与PI-LL错配相关（OR; 2.0- 2.4）。结论MC和DD与PI-LL错配显著相关。因此，侧写MC可能有助于提高LBP合并成人脊柱畸形的靶向治疗。
PurposeSagittal plane alignment is crucial for treating spinal malalignment and low back pain. Pelvic incidence–lumbar lordosis (PI–LL) mismatch is commonly used to evaluate clinical outcomes in patients with sagittal malalignment. The association between PI–LL mismatch and changes surrounding the intervertebral disc is very important to understand the compensatory mechanisms involved. This study aimed to examine the association between PI–LL mismatch and magnetic resonance imaging (MRI) changes surrounding the intervertebral disc in a large population-based cohort.MethodsWe evaluated participants from the second Wakayama Spine Study, recruiting the general population aged 20 years or older, irrespective of sex, who were registered residents in one region in 2014. In total, 857 individuals underwent an MRI of the whole spine; however, 43 MRI results were not included due to incomplete or inadequate quality images. PI–LL mismatch was defined as > 11°. We compared the MRI changes, such as Modic change (MC), disc degeneration (DD), and high-intensity zones (HIZ), between PI–LL mismatch and non-PI–LL mismatch groups. Multivariate logistic regression analysis was conducted to determine the association between the MRI changes and PI–LL mismatch with adjustment for age, sex, and body mass index in the lumbar region and at each level.ResultsA total of 795 participants (243 men, 552 women, mean age 63.5 ± 13.1 years old) were evaluated; 181 were included in the PI–LL mismatch group. MC and DD in the lumbar region were significantly higher in the PI–LL mismatch group. MC in the lumbar region was significantly associated with PI–LL mismatch (odds ratio (OR); 1.81, 95% confidence interval (CI) 1.2–2.7). MC at each level was significantly associated with PI–LL mismatch (OR; 1.7–1.9, 95%CI 1.1–3.2), and DD at L1/2, L3/4, and L4/5 was associated with PI–LL mismatch (OR; 2.0- 2.4. 95%CI 1.2–3.9).ConclusionMC and DD were significantly associated with PI–LL mismatch. Therefore, profiling MC may be helpful in improving the targeted treatment of LBP associated with the adult spinal deformity.