与终板硬化相关的Modic改变(MCs)可以防止腰椎间斜角融合(OLIF)中的椎间融合器下沉。

PubMed ID
发表日期 2020年06月

原始出处 世界神经外科
World neurosurgery
作者 Liu  Junhui  Ding  Wenyuan  Yang  Dalong  Wu  Hao  Hao  Lu  Hu  Zhijun  Fan  Shunwu  Zhao  Fengdong 

文献标题 与终板硬化相关的Modic改变(MCs)可以防止腰椎间斜角融合(OLIF)中的椎间融合器下沉。
Modic Changes (MCs) Associated with Endplate Sclerosis Can Prevent Cage Subsidence in Oblique Lumbar Interbody Fusion (OLIF) Stand-Alone.

文献摘要 OBJECTIVE

探讨Modic改变(MCs)与终板硬化的关系,以及MCs和终板硬化对腰椎间斜角融合(OLIF)患者椎间融合器塌陷的影响。

METHODS

我们纳入了从2015年8月到2017年8月接受OLIF独立治疗的78名住院患者。所有患者均行CT和mri检查。评估MCs的存在和类型。根据矢状位重建CT图像评价终板硬化。在1个月、3个月、6个月和12个月的随访中评估笼的沉降。

RESULTS

78例患者中,92个椎间盘接受了无后路固定的OLIF手术,其中32个(34.8%)有MCs。Ⅰ型、Ⅱ型和Ⅲ型MCs分别见于10个(10.9%)、19个(20.7%)和3个(3.2%)终板。在32个有MCs的终板中,10个(31.3%)在CT图像上显示硬化迹象,其中2个(20%)为Ⅰ型MCs,5个(26.3%)为Ⅱ型,3个(100%)为Ⅲ型MCs。在60个无MCs的终板中,5个(8.3%)显示硬化迹象。无MCs组的笼沉降率高于MCs组(P<0.01)。MCs组(n=32)仅发现1例cage沉陷,属于MCsⅠ型,而非MCs组(n=60)有6例cage沉陷。硬化和非硬化终板的Hounsfield单位比值分别为2.2±0.3和1.1±0.1。硬化终板组(n=15)无椎间融合器塌陷,而非硬化终板组(n=77)有7例椎间融合器塌陷。

CONCLUSION

与终板硬化相关的MCs可以防止OLIF独立模型的椎间盘塌陷。


OBJECTIVE

To investigate the association between Modic changes (MCs) and endplate sclerosis; and to investigate the effect of MCs and endplate sclerosis on cage subsidence in oblique lumbar interbody fusion (OLIF) stand-alone.

METHODS

We included 78 inpatients who underwent OLIF stand-alone from August 2015 to August 2017. All patients underwent computed tomography (CT) and magnetic resonance imaging. The presence and the types of MCs were assessed. Endplate sclerosis was evaluated from sagittally reconstructed CT images. Cage subsidence was evaluated at the 1-, 3-, 6-, and 12-month follow-up.

RESULTS

Of 78 patients, 92 discs underwent OLIF without posterior instrumentation; 32 of 92 (34.8%) had MCs. Type I, II, and III MCs were seen in 10 (10.9%), 19 (20.7%), and 3 (3.2%) endplates, respectively. Among 32 endplates with MCs, 10 (31.3%) showed evidence of sclerosis on CT images, including 2 of 10 endplates (20%) with type I MCs, 5 of 19 (26.3%) with type II, and 3 of 3 (100%) with type III. Among 60 endplates without MCs, 5 (8.3%) showed evidence of sclerosis. Cage subsidence rate in the no-MCs group was higher than that in the MCs group (P <0.01). We found only 1 case of cage subsidence in the MCs group (n = 32), which was classified as MCs type I, whereas 6 cases of cage subsidence were observed in the no-MCs group (n = 60). Hounsfield unit ratios for sclerotic and no-sclerotic endplates were 2.2 ± 0.3 and 1.1 ± 0.1, respectively. No subsidence of cage was found in the sclerotic endplates group (n = 15), whereas 7 cases of cage subsidence were found in the no-sclerotic group (n = 77).

CONCLUSION

MCs associated with endplate sclerosis can prevent cage subsidence in OLIF stand-alone.


获取全文 10.1016/j.wneu.2020.02.047