腰椎形态改变的MRI表现与腰痛、疼痛相关残疾和生活质量之间的关系：一项横断面研究。

IF 3.9 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Academic Radiology Pub Date : 2025-10-01 DOI:10.1016/j.acra.2025.06.026

Daishui Yang MD , Luis Becker MD , Bernhard U. Hoehl MD , Lukas Mödl MSc , Tianwei Zhang MD , Sihai Liu MD , Torsten Diekhoff MD , Sandra Reitmaier Med.vet , Matthias Pumberger MD , Hendrik Schmidt PhD

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引用次数: 0

摘要

基本原理和目的：本研究探讨了常见的腰椎形态变化(包括椎间盘退变（IDD）、椎间盘突出（IDH）、高强度区（HIZ）、小关节退变（FJD）和modc变化（MCs）之间的关系，以及它们对腰痛（LBP）特征、残疾和生活质量的综合影响。方法：本研究纳入712名参与者，其中254名无背痛（no- bp）， 159名间歇性腰痛（iLBP）， 299名慢性腰痛（cLBP）。所有被招募的参与者都完成了问卷调查、临床检查和MRI扫描。采用二元logistic回归和线性模型评估腰椎形态变化与腰痛特征、腰痛所致残疾和生活质量之间的关系。结果：有单一MRI异常的参与者，包括IDD、IDH和MCs，被发现与cLBP和iLBP的几率更高相关。MRI检查中观察到的结构改变越多，cLBP和iLBP的几率越大。此外，发现患有IDD和HIZ的参与者经历更长的LBP发作（β 2.5, 95% CI 0.7-4.3, p=0.008和β 3.5, 95% CI 0.8-6.1, p=0.010）。MCs是唯一与LBP最大强度相关的MRI异常（β 0.5, 95% CI 0.1-1.0, p=0.026）。FJD被发现与应激下发生的腰痛发病模式相关（OR 1.9, 95% CI 1.1-3.2, p=0.014）。MRI异常数量与LBP最大强度之间存在相关性（p为趋势=0.001）。此外，MCs还被观察到与更大的残疾和身体健康相关（β 1.2, 95% CI 0.2-2.1, p=0.009和β -7.1, 95% CI -11至-3.6,p）。结论：我们的研究表明，单形态变化与腰痛特征、功能障碍和生活质量之间存在关联。这些关联随着形态学变化的增多而更加明显。进一步的工作应该旨在阐明潜在的因果机制，并评估MRI结果作为诊断腰痛指标的有效性。

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Association Between MRI Findings of Lumbar Morphometric Changes and the Characteristics of Low Back Pain, Pain-Related Disability, and Quality of Life: A Cross-sectional Study

Rationale and Objectives

This research explored the association between common lumbar morphometric changes—including intervertebral disc degeneration (IDD), intervertebral disc herniation (IDH), high-intensity zone (HIZ), facet joint degeneration (FJD), and Modic changes (MCs)—and their combined effect on the characteristics of low back pain (LBP), disability and quality of life.

Methods

712 participants were included in this study, including 254 no back pain (no-BP), 159 intermittent LBP (iLBP), and 299 chronic LBP (cLBP). All recruited participants underwent questionnaire completion, clinical examination, and MRI scanning. Binary logistic regression and linear models were conducted to assess the relationship between lumbar morphometric changes and the characteristics of LBP, disability caused by LBP and quality of life.

Results

Participants with single MRI abnormalities, including IDD, IDH, and MCs, were found to be associated with greater odds of cLBP and iLBP. The greater number of structural changes observed in MRI findings was associated with greater odds of cLBP and iLBP. In addition, participants with IDD and HIZ were found to experience a longer episode of LBP (β 2.5, 95% CI 0.7–4.3, p = 0.008 and β 3.5, 95% CI 0.8–6.1, p = 0.010, respectively). MCs were the only MRI abnormalities associated with maximum intensity of LBP (β 0.5, 95% CI 0.1–1.0, p = 0.026). FJD was found to be associated with LBP onset patterns occurring under stress (OR 1.9, 95% CI 1.1–3.2, p = 0.014). There was an association between the number of MRI abnormalities and the maximum intensity of LBP (p for trend = 0.001). Furthermore, MCs were also observed associated with greater disability and physical health (β 1.2, 95% CI 0.2–2.1, p = 0.009 and β −7.1, 95% CI −11 to −3.6, p<0.001). Participants with greater number of morphometric changes shown increased disability (p for trend = 0.005) and reduced quality of life (p for trend <0.001).

Conclusion

Our study shown an association between single morphometric changes and the characteristics of LBP, functional impairment and quality of life. These associations were more pronounced with the greater number of morphometric changes. Further work should aim to clarify the underlying causal mechanisms and assess the effectiveness of MRI findings as indicators for diagnosing LBP.

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来源期刊

Academic Radiology 医学-核医学

CiteScore

7.60

自引率

10.40%

发文量

432

审稿时长

18 days

期刊介绍： Academic Radiology publishes original reports of clinical and laboratory investigations in diagnostic imaging, the diagnostic use of radioactive isotopes, computed tomography, positron emission tomography, magnetic resonance imaging, ultrasound, digital subtraction angiography, image-guided interventions and related techniques. It also includes brief technical reports describing original observations, techniques, and instrumental developments; state-of-the-art reports on clinical issues, new technology and other topics of current medical importance; meta-analyses; scientific studies and opinions on radiologic education; and letters to the Editor.