Patterns of lumbar disc degeneration are different in degenerative disc disease and disc prolapse magnetic resonance imaging analysis of 224 patients
Patterns of lumbar disc degeneration are different in degenerative disc disease and disc prolapse magnetic resonance imaging analysis of 224 patients
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DOI：
10.1016/j.spinee.2013.10.042
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发表时间：
2014-02-01
期刊：
影响因子：
4.5
通讯作者：
Rajasekaran, S.
中科院分区：
文献类型：
--
作者：
Kanna, Rishi M.;Shetty, Ajoy Prasad;Rajasekaran, S.
背景：腰椎间盘退变的病因、发病机制、症状、预防和治疗等方面的现有研究尚无定论。椎间盘退行性疾病（DDD）和椎间盘脱垂（DP）是影响腰椎间盘的常见疾病。尽管它们在临床上表现不同，但现有的椎间盘退变研究包括了具有这两种特征的患者，导致观察结果差异很大。DDD和DP之间可能的关系或不影响尚未得到充分评估。目的：分析慢性腰痛伴DDD患者和急性DP患者腰椎间盘退变的特点。研究设计：前瞻性、基于磁共振成像的放射学研究。方法：前瞻性研究两组患者（年龄20 ~ 50岁）。组1包括急性DP需要单节段微椎间盘切除术的患者。第二组包括慢性腰痛和DDD患者。通过磁共振成像对所有5个腰椎间盘的Pfirmann分级、Schmorl淋巴结、Modic变化和终板损伤总评分来评估椎间盘。结果：1组（DP） 91例，2组（DDD） 133例。DP和DDD患者在退变的数量、程度和严重程度上存在显著差异。DDD患者椎间盘退变数量明显高于DP患者(p
BACKGROUND CONTEXT: Existing research on lumbar disc degeneration has remained inconclusiveregarding its etiology, pathogenesis, symptomatology, prevention, and management. Degenerative disc disease (DDD) and disc prolapse (DP) are common diseases affecting the lumbar discs. Although they manifest clinically differently, existing studies on disc degeneration have included patients with both these features, leading to wide variations in observations. The possible relationship or disaffect between DDD and DP is not fully evaluated.PURPOSE: To analyze the patterns of lumbar disc degeneration in patients with chronic back pain and DDD and those with acute DP.STUDY DESIGN: Prospective, magnetic resonance imaging-based radiological study.METHODS: Two groups of patients (aged 20-50 years) were prospectively studied. Group 1 included patients requiring a single level microdiscectomy for acute DP. Group 2 included patients with chronic low back pain and DDD. Discs were assessed by magnetic resonance imaging through Pfirmann grading, Schmorl nodes, Modic changes, and the total end-plate damage score for all the five lumbar discs.RESULTS: Group 1 (DP) had 91 patients and group 2 (DDD) had 133 patients. DP and DDD patients differed significantly in the number, extent, and severity of degeneration. DDD patients had a significantly higher number of degenerated discs than DP patients (p