通讯作者: 曹威, 529317642@qq.com

DOI：10.12201/bmr.202502.00046

Correlation between Modic changes of lumbosacral vertebrae and hip bone mineral density in patients with low back pain

• 摘要：目的: 研究腰痛患者腰骶椎Modic改变（MCs）及其类型与骨质疏松的关系。方法: 以204例腰痛为主要症状的40-70岁女性患者为研究对象，收集年龄、MCs分型、髋部（全髋关节和股骨颈）BMD值及其T值。据是否存在MCs分为MCs组（139例，68.14%）及无MCs组（65例，31.86%），并将MCs组据MCs分型分为Ⅰ型（33例）、Ⅱ型（90例）、Ⅲ 型（16例）3 组。对MCs组与无MCs组年龄、髋部BMD值及其T值进行差异性分析，并对MCs各组与无MCs组4组年龄、髋部BMD值及其T值进行差异性分析。结果: MCs组和无MCs组年龄、髋部BMD值及相应T值差异均不具有统计学意义（P＞0.05）。对4组年龄采用Kruskal-Wallis检验分析显示其差异不具有统计学意义（P＞0.05）。4组髋部BMD值及其T值数据均符合正态分布，其均值从大到小排列依次均为：Ⅲ型组＞无MCs组＞Ⅱ型组＞Ⅰ型组。Ⅲ型组多处于骨量正常水平，余3组多处于骨量减少及骨质疏松水平。对4组髋部BMD值及其T值进行参数检验多重比较（LSD法），结果显示：Ⅱ型组与无MCs组骨量差异不具有统计学意义（P＞0.05），Ⅰ型组与余3组、Ⅱ型组与Ⅲ型组及Ⅲ型组与无MCs组骨量差异均具有统计学意义（P＜0.05）。结论: 不同骨量水平有相应类型的MCs发病倾向：较高骨量（骨量正常）多发生Ⅲ型MCs，骨量减少或骨质疏松则易发Ⅰ型MCs，Ⅱ型MCs骨量水平多与同龄人群相匹配；具有Ⅰ型MCs的腰痛患者应重视抗骨质疏松治疗。

  关键词： 腰痛；终板炎；Modic 改变；骨密度; ; ; 

   

  Abstract: Objective Study the Modic changes(MCs)in the lumbar and sacral spine of patients with low back pain and their relationship with osteoporosis. Methods The study included 204 women aged 40-70 years with lumbar pain as the main symptom. The researchers collected data on age, MCs subtype, hip BMD values and T-scores. The patients were divided into two groups based on the presence or absence of MCs in the lumbar spine: the MCs group (139 patients, 68.14%) and the non-MCs group (65 patients, 31.86%). The MCs group was further divided into three subgroups based on MCs subtype: Group type Ⅰ (33 patients), Group type Ⅱ (90 patients), and Group type Ⅲ (16 patients). The researchers conducted a comparative analysis of age, hip BMD values and T-scores between the MCs group and the non-MCs group, and between the three subgroups of the MCs group and the non-MCs group. Results In the group with MCs and the group without MCs, there was no significant difference in age, hip BMD value, and corresponding T value (P>0.05). The Kruskal-Wallis test showed no significant difference in age among the four groups (P>0.05). The data of hip BMD value and T value in all four groups were normally distributed, and the mean values were ranked in the order of type Ⅲ group >non-MCs group > type Ⅱ group >type Ⅰ group. The type Ⅲ group was mostly at the normal level of bone mass, while the remaining three groups were mostly at the level of reduced bone mass and osteoporosis. The LSD method was used for multiple comparisons of hip BMD value and T value parameters (P<0.05). The results showed that the difference in bone mass between the type Ⅱ group and the non-MCs group was not statistically significant (P>0.05),and the differences in bone mass between the type Ⅰ group and the remaining three groups, between the type Ⅱ group and the type Ⅲ group, and between the type Ⅲ group and the non-MCs group were all statistically significant(P<0.05). Conclusion Different bone mass levels have corresponding types of MCs: higher bone mass (normal bone mass) often leads to type Ⅲ MCs, while osteopenia or osteoporosis is prone to type Ⅰ MCs, and the bone mass level of type Ⅱ MCs is mostly matched with the same age group.. It is suggested that patients with low back pain with type Ⅰ of MCs should be payed attention to anti-osteoporosis treatment.

  Key words: low back pain; endplateitis; modic changes; bone mineral density

  提交时间：2025-02-24

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• 序号	提交日期	编号	操作
  1	2025-02-09	bmr.202502.00046V1	下载

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