PDF(Pubmed)
Abstract：
BACKGROUND: Low back pain (LBP) affects a significant proportion of the adult population. Potent anti-resorptive drugs such as intravenous zoledronic acid have been demonstrated to reduce Modic changes (MCs) upon magnetic resonance imaging (MRI) of the spine and concomitantly decrease associated LBP. It is uncertain whether oral alendronic acid has a similar effect.
METHODS: 82 subjects were recruited in this case-control study. Treatment subjects (n = 41) received oral alendronic acid treatment for at least 1-year and were matched by gender and age (± 2) to control subjects (n = 41) not receiving any anti-osteoporotic medication. The prevalence, type, and extent of MCs were quantified upon T1 and T2-weighted MRIs of the lumbosacral spine.
RESULTS: Treatment subjects received oral alendronic acid for 124.0 ± 62.1 weeks at the time of MRI assessment and exhibited a lower prevalence of MCs over the lumbosacral spine (18/41 vs. 30/41, p < 0.001) as compared to control subjects. Amongst both groups, type 2 MCs were predominant. Quantification of type 2 MCs in treatment subjects revealed a significant reduction in area (113 ± 106 mm2 vs. 231 ± 144 mm2, p < 0.01) and volume (453 ± 427 mm3 vs. 925 ± 575 mm3, p < 0.01) affected by type 2 MCs in comparison to matched controls.
CONCLUSIONS: Oral alendronic acid may be useful in the treatment of MC-associated LBP in patients with concomitant osteoporosis.
METHODS: 82 subjects were recruited in this case-control study. Treatment subjects (n = 41) received oral alendronic acid treatment for at least 1-year and were matched by gender and age (± 2) to control subjects (n = 41) not receiving any anti-osteoporotic medication. The prevalence, type, and extent of MCs were quantified upon T1 and T2-weighted MRIs of the lumbosacral spine.
RESULTS: Treatment subjects received oral alendronic acid for 124.0 ± 62.1 weeks at the time of MRI assessment and exhibited a lower prevalence of MCs over the lumbosacral spine (18/41 vs. 30/41, p < 0.001) as compared to control subjects. Amongst both groups, type 2 MCs were predominant. Quantification of type 2 MCs in treatment subjects revealed a significant reduction in area (113 ± 106 mm2 vs. 231 ± 144 mm2, p < 0.01) and volume (453 ± 427 mm3 vs. 925 ± 575 mm3, p < 0.01) affected by type 2 MCs in comparison to matched controls.
CONCLUSIONS: Oral alendronic acid may be useful in the treatment of MC-associated LBP in patients with concomitant osteoporosis.
摘要：
背景：下腰痛（LBP）影响了成年人口的很大一部分。有效的抗再吸收药物如唑来膦酸已被证明可减少脊柱磁共振成像（MRI）时的Modic变化（MC），并同时降低相关的LBP。不确定口服阿仑膦酸是否具有类似的效果。
方法：本病例对照研究招募了82名受试者。治疗受试者（n=41）接受口服阿仑膦酸治疗至少1年，性别和年龄（±2）与未接受任何抗骨质疏松药物的对照受试者（n=41）相匹配。患病率,type,根据T1和T2加权MRI对MC的范围进行量化。
结果：治疗对象在MRI评估时口服阿仑膦酸124.0±62.1周，并且表现出腰骶椎MC的患病率较低（18/41vs.30/41，p<0.001）与对照受试者相比。在两组中，以2型MC为主。治疗对象中2型MC的定量显示面积显着减少（113±106mm2与231±144mm2，p<0.01）和体积（453±427mm3与925±575mm3，p<0.01）与匹配的对照相比受2型MC的影响。
结论：口服阿仑膦酸可用于合并骨质疏松症患者MC相关LBP的治疗。
方法：本病例对照研究招募了82名受试者。治疗受试者（n=41）接受口服阿仑膦酸治疗至少1年，性别和年龄（±2）与未接受任何抗骨质疏松药物的对照受试者（n=41）相匹配。患病率,type,根据T1和T2加权MRI对MC的范围进行量化。
结果：治疗对象在MRI评估时口服阿仑膦酸124.0±62.1周，并且表现出腰骶椎MC的患病率较低（18/41vs.30/41，p<0.001）与对照受试者相比。在两组中，以2型MC为主。治疗对象中2型MC的定量显示面积显着减少（113±106mm2与231±144mm2，p<0.01）和体积（453±427mm3与925±575mm3，p<0.01）与匹配的对照相比受2型MC的影响。
结论：口服阿仑膦酸可用于合并骨质疏松症患者MC相关LBP的治疗。
