《中国康复理论与实践》 ›› 2012, Vol. 18 ›› Issue (5): 458-460.

• 论文 • 上一篇    下一篇

腰椎间盘突出症磁共振成像下终板形态及其与椎间盘退变的关系

李春林1,2,李放1,张志成1,叶超群1

  

  1. 1.北京军区总医院骨科,北京市 100700;2.山西医科大学第二临床医学院,山西太原市 030001。
  • 收稿日期:2012-01-16 修回日期:2012-03-28 出版日期:2012-05-25 发布日期:2012-05-25

Relationship between Endplate Shape on Magnetic Resonance Imaging and Disc Degeneration in Herniated Nucleus Pulposus

LI Chun-lin, LI Fang, ZHANG Zhi-cheng, et al.   

  1. General Hospital of Beijing Military Area, Beijing 100700, China
  • Received:2012-01-16 Revised:2012-03-28 Published:2012-05-25 Online:2012-05-25

摘要: 目的研究腰椎间盘突出患者下腰椎MRI 终板形态的分布规律,分析终板形态和椎间盘突出、Modic 改变的关系。方法回顾分析110 例腰椎间盘突出患者术前腰椎MRI。根据正中矢状面T1像将终板形态分型。根据Pfirrmann 法评定椎间盘退变等级。结果下腰椎终板最常见形态为凹面型。随着节段的下降,平坦型终板逐渐多见,L5~S1节段主要为平坦型。不规则型终板最少,且主要集中在L5~S1节段。终板形态由凹面型到平坦型再到不规则型,对应的间盘退变程度逐渐加重(P<0.05)。椎间盘突出节段以平坦型和不规则型终板多于凹面型多见,无突出节段则以凹面型多见(P<0.01),而平坦型和不规则型间无显著性差异(P>0.01)。不规则型终板比凹面型和平坦型更容易伴发Modic 改变(P<0.01),凹面型和平坦型间无显著性差异(P>0.01)。结论终板形态变化能在一定程度上反映椎间盘突出时间盘的退变情况。不规则型终板更容易伴发Modic 改变。

关键词: 腰椎间盘突出, 磁共振成像, 终板, 椎间盘退变, Modic 改变

Abstract: Objective To investigate endplate shape in low lumbar spine in patients with herniated nucleus pulposus, and analyze the relationshipbetween endplate shape and herniation of intervertebral disc, Modic changes. Methods The preoperative MRI of 110 patients wasreviewed. The endplate shape was divided into 3 types. Disc degeneration was classified with the Pfirrmann's way. Results Concave typewas the most common in the lower lumbar spine. Flat was more prevalent in lower than in upper. The L5~S1 segment was flat in most cases.Irregular type was the least and mainly appeared at the L5~S1 segment. Disc degeneration worsened from concave, flat, to irregular. Herniatedintervertebral disc dominated with flat and irregular endplates, and no-herniated ones dominated with concave. Modic changes more associatedwith irregular endplates. Conclusion Endplate shape may respond to the disc degeneration. Modic changes associate with irregularendplate.

Key words: lumbar disc herniation, magnetic resonance imaging, endplate, disc degeneration, Modic changes