Characteristics and natural course of vertebral endplate signal (Modic) changes in the Danish general population
Characteristics and natural course of vertebral endplate signal (Modic) changes in the Danish general population
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DOI：
10.1186/1471-2474-10-81
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发表时间：
2009-07-03
影响因子：
2.3
通讯作者：
Kjaer, Per
中科院分区：
文献类型：
--
作者：
Jensen, Tue S.;Bendix, Tom;Kjaer, Per
背景资料：椎体终板信号改变（VESC）在腰痛（LBP）和/或坐骨神经痛患者中比不寻求背痛治疗的人更常见。已在临床和非临床人群中描述了VESC的分布和特征。然而，虽然已经在患者中研究了VESC的临床病程，但尚未报道一般人群的自然病程。这项前瞻性观察研究的目的是描述：1）VESC在腰椎中的分布和特征，2）其与椎间盘退变的相关性，3）40至44岁的自然病程。344个人从丹麦一般人群中抽样的161名男性和183名女性在40岁时和44岁时进行MRI检查。使用标准化评价方案评价以下MRI结果：VESC的类型、位置和大小、椎间盘信号和椎间盘高度。用频数表分析了VESC的特征和分布。采用Logistic回归分析VESC与椎间盘退变的关系。VESC的类型和大小的变化进行了分析，交叉表格的变量在40岁和44岁，并使用McNemar的测试symmetrical.Results：三分之二（67%）的VESC发现在这项研究中位于脊柱的下部（L4-S1）。位于椎间盘L1-L3节段的VESC通常较小，仅位于椎体前部，而位于椎间盘L4-S1节段的VESC更可能进一步延伸到椎体内并沿着终板延伸。而且，VESC向椎体内延伸越多，邻近椎间盘退变的可能性越大。从40岁到44岁，VESC终板水平的患病率从6%显著增加到9%。再次，VESC，只观察到在终板是更有可能来和去的四年期间相比，进一步延伸到椎骨，在那里它一般sustained.Conclusion：VESC的患病率显着增加，在四年期间。此外，本研究的结果表明，VESC的分布，其与椎间盘退变及其自然病程的相关性，取决于信号变化的大小。
Background: Vertebral endplate signal changes (VESC) are more common among patients with low back pain (LBP) and/or sciatica than in people who are not seeking care for back pain. The distribution and characteristics of VESC have been described in people from clinical and non-clinical populations. However, while the clinical course of VESC has been studied in patients, the natural course in the general population has not been reported. The objectives of this prospective observational study were to describe: 1) the distribution and characteristics of VESC in the lumbar spine, 2) its association with disc degeneration, and 3) its natural course from 40 to 44 years of age.Methods: Three-hundred-and-forty-four individuals (161 men and 183 women) sampled from the Danish general population had MRI at the age of 40 and again at the age of 44. The following MRI findings were evaluated using standardised evaluation protocols: type, location, and size of VESC, disc signal, and disc height. Characteristics and distribution of VESC were analysed by frequency tables. The association between VESC and disc degeneration was analysed by logistic regression analysis. The change in type and size of VESC was analysed by cross-tabulations of variables obtained at age 40 and 44 and tested using McNemar's test of symmetry.Results: Two-thirds (67%) of VESC found in this study were located in the lower part of the spine (L4-S1). VESC located at disc levels L1-L3 were generally small and located only in the anterior part of the vertebra, whereas those located at disc levels L4-S1 were more likely to extend further into the vertebra and along the endplate. Moreover, the more the VESC extended into the vertebra, the more likely it was that the adjacent disc was degenerated. The prevalence of endplate levels with VESC increased significantly from 6% to 9% from age 40 to 44. Again, VESC that was only observed in the endplate was more likely to come and go over the four-year period compared with those which extended further into the vertebra, where it generally persisted.Conclusion: The prevalence of VESC increased significantly over the four-year period. Furthermore, the results from this study indicate that the distribution of VESC, its association with disc degeneration and its natural course, is dependent on the size of the signal changes.