腰椎Modic改变的研究进展

Research Progress of Lumbar Modic Changes

摘要: 伴随人口老龄化加剧，慢性腰痛已成为影响国民健康的重要公共卫生问题。腰椎Modic改变(MC)作为与椎间盘退变密切相关的椎体终板及终板下骨髓影像学异常，其发生率与年龄显著相关，具有典型的分型及年龄分布特征。本文系统综述腰椎Modic改变的病理学特征、分型体系、发生机制(生物力学、生物化学、自身免疫、感染、遗传等)、临床表现、影像学特点及保守治疗、药物治疗、手术治疗与生物治疗等研究进展，梳理MC从病理机制到临床诊疗的全链条研究现状，为临床早期识别、精准干预及预后评估提供理论依据，同时展望其在靶向抗炎、免疫调节、生物修复等领域的研究方向。

Abstract: With the accelerating aging of the population, chronic low back pain has become an important public health problem affecting national health. Lumbar Modic changes (MC) are imaging abnormalities of the vertebral endplate and subchondral bone marrow closely related to intervertebral disc degeneration. The incidence of MC is significantly age-related, with typical classification and age distribution characteristics. This article systematically reviews the research progress of lumbar Modic changes, including pathological features, classification system, pathogenesis (biomechanics, biochemistry, autoimmunity, infection, genetics, etc.), clinical manifestations, imaging features, conservative treatment, medication, surgical treatment and biological therapy. It sorts out the current research status of MC from pathological mechanism to clinical diagnosis and treatment, provides a theoretical basis for early clinical recognition, precise intervention and prognosis evaluation, and prospects its research directions in targeted anti-inflammation, immunoregulation and biological repair.