Modic Meta 921 ( 300052 ) : MRI Modic (low back painlbp) : MEDLINE EMBASE Cochrane Controlled Clinical Trials Register Modic (1) ( ) Modic ;(2) ( ) Modic Meta Review Manager 4.2( Cochrane Libirary) (Random-effect model) (odds ratioor) Modic : 6 Meta 6 966 3026 OR 3.66(95%CI1.46~9.15) 1 Modic 2 Modic OR 1.31(95%CI0.35~4.96) : Modic ; 2 Modic 1 Modic Modic ; ;Meta doi:10.3969/j.issn.1004-406x.2009.12.10 :R681.5 :A :1004-406X(2009)-12-0921-06 Meta -analysis of the relationship between Modic changes and low back pain/li BingWANG Pei FENG Shiqinget al//chinese Journal of Spine and Spinal Cord200919(12):921~926 Abstract Objective:To determine the relationship between Modic changes and low back pain(lbp) through Meta -analysis.method:medlineembase and Cochrane Controlled Clinical Trials Register databases were carefully searched to determine relevant papers.the parameter index for Meta-analysis included the number of symptomatic lumbar discs which pain can be provoked by discography or not(with pain similar to the primary) as well as the number with Modic changes among them.the results were brought to Review Manager 4.2 (download from Cochrane Library) and measured using odds ratio(or) under Random-effect model for sensitivity analysis.further comparative analysis between the subgroups was performed thereafter.result:after screening outa total of 6 papers were meet our inclusion criterion for Meta-analysis.There were 966 cases and 3026 discs.the combined OR value for pain group and painless group after discography was 3.66 (95% CI1.46-9.15).While the combined OR value for type 1 and type 2 Modic change in pain group after discography was 1.31(95%CI0.35-4.96).Conclusion:There is higher incidence rate of Modic changes in LBP patients compared with those in no LBP patients.no evidence available supports type 1 Modic changes is more relevant to low back pain. Key words Modic changes;low back pain;meta analysis Author s address Department of OrthopedicsTianjin Medical University General HospitalTianjin300052 China 20% (magnetic resonance imagingmri) (Modic ) [1] Modic : (1982-) :(022)60362636 E-mail:braveman1982@163.com : Modic [2~5] Modic
922 ;(7)MRI [7 8] Modic :1 T1 Modic ;3 T1 T2 Meta 1 2 Modic Modic 3 Modic [9 10] 1 1 2 Modic 3 1.1 Modic Meta :(1) :(1) Modic Modic ;(2) Modic ;(2) 1 Modic MRI ;(3) 2 Modic ;(4) 20 1.2 MEDLINE EMBASE Cochrane ; Controlled Clinical Trials Register Low back pain 1.4 Modic changes Discography 1984 MRI (Revmanthe Cochrane CollaborationOxfordUnited Kingdom) 1984 1 ~2009 6 (fixed-effects model) Meta (random-effects model) Meta (Odds T2 ;2 T1 T2 Meta Modic Review Manager 4.2 ratioor ) 1.3 95% Meta (the Meta -analysis of Observational Studies in Epidemiology GroupMOOSE) 2 [6] Meta 2.1 Modic :(1) 306 ;(2) Modic ;(3) ;(4) 291 15 8 ;(5) ( 1 ) ; (6) MRI Meta 6 ( 1) [4 5 11~14] 5
923 3 [4 5 11~13] ;1 1987 de Roos [14] [15] MRI 1988 Modic [7 8] 1988 Modic Modic 474 Modic (Modic changes) [7 8] 4 20 [4 11 13 14] Modic Modic 2 Modic Modic LBP [5 12] Meta 2 2 MRI Modic ( [16~19] 4 ) 2.2 Meta Modic 6 Modic LBP [2~5] [11~14 20~22] (P<0.05I2=82.5%) (random-effects model) OR ( 3.66(95%CI1.46~9.15) Z=2.77 P=0.006( 1) Modic 1 2 4 (P<0.05I2=89.9%) Modic ) (random-effects model) OR 1.31(95%CI0.35~4.96) Z=0.40P=0.69( 2) Meta Meta 1 Meta Modic MRI ( ) Braithwaite [11] 1998 58 31 42.00 152 31 0.5T-1.5T Ito [12] 1998 39 17 37.00 101 9 1.5T Weishaupt [13] 2001 50 27 42.40 116 26 1.0T Kokkonen [4] 2002 36 22 40.00 103 39 Lim [5] 2004 47 20 43.00 97 14 1.5T Thompson [14] 2009 736 43.00 2457 312 2 Meta Braithwaite [11] Ito [12] Weishaupt [13] Kokkonen [4] Lim [5] Thompson Modic MRI MRI [14]
924 1 2 1 Modic Meta 2 Modic Meta (Modic ) Meta Modic Modic 1090 Modic Modic 1936 OR 3.66 :(1) (Z=2.77P=0.006) Modic [9] ;(2) Meta Modic 6 (P <0.05I2 = 82.5%) :(1) ( ) ( ) ;(2) MRI ;(3) [23~25] Modic [26 27] 1 Modic Meta 2 Modic 4 1 Modic 152 2 Modic Meta 61 OR 1.31 (Z=0.40P=0.69)
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