O'Neill T W, McCloskey E V, Kanis J A, Bhalla A K, Reeve J, Reid D M, Todd C, Woolf A D, Silman A J
ARC Epidemiology Research Unit, Manchester University, United Kingdom.
J Rheumatol. 1999 Apr;26(4):842-8.
Vertebral osteophytes are a characteristic feature of intervertebral disc degeneration. There are, however, few population data concerning the occurrence of and clinico-biological correlates of vertebral osteophytes in both the dorsal and lumbar spine. Our purpose was to determine the frequency and distribution of anterior osteophytes in the thoracic and lumbar spine, and their relationship with both various putative risk factors, including physical activity and obesity, and self-reported back pain.
Men and women aged 50 years and over were recruited from primary care based registers in 5 UK centers. They were invited to attend for an interviewer administered lifestyle questionnaire, assessment of height and weight, and lateral spinal radiographs. Lateral spinal radiographs were evaluated by a single observer for the presence of osteophytes from T4 to L5 using a semiquantitative score (grade): 0 = none, 1 = doubtful, 2 = mild, 3 = moderate, 4 = severe. Based on these data 2 summary statistics were derived: the maximum osteophyte grade at any vertebral level (MAX), and the sum of the osteophyte grades at the individual vertebral levels (TOT).
In total, 681 women, mean age 63.3 years, and 499 men, mean age 63.7 years, were studied; 84% of men and 74% of women had at least one vertebral level with a grade 1 or higher osteophyte. Both the sum of the individual grades (TOT) and the proportion of subjects with MAX > or =2 were greater in men than in women in both the dorsal and lumbar spine, and both increased with age. The pattern of spinal involvement was similar in the sexes, with osteophytes occurring most frequently at T9-10 and L3. Increasing body mass index was associated with more frequent osteophytes at both dorsal and lumbar spine, although the relationship was stronger at the dorsal spine. Heavy physical activity, particularly in young adult life, was associated with osteophytosis in men. Self-reported back pain, both ever and in the past year, was linked with lumbar osteophytes in men.
The distribution within the spine in our study and the relationship with heavy physical activity points to mechanical factors being important in pathogenesis of vertebral osteophytosis. Prospective studies are needed to explore the types of physical activity that increase susceptibility to vertebral osteophytosis. In men, osteophytes affecting the lumbar spine are associated with back pain.
椎体骨赘是椎间盘退变的一个特征性表现。然而，关于胸段和腰段脊柱椎体骨赘的发生率及其临床生物学相关性的人群数据较少。我们的目的是确定胸段和腰段脊柱前缘骨赘的频率和分布情况，以及它们与各种假定危险因素（包括体力活动和肥胖）和自我报告的背痛之间的关系。
从英国5个中心的基层医疗登记处招募年龄在50岁及以上的男性和女性。邀请他们参加由访员管理的生活方式问卷、身高和体重评估以及脊柱侧位X线片检查。由一名观察者使用半定量评分（分级）对脊柱侧位X线片从T4至L5进行骨赘评估：0级 = 无，1级 = 可疑，2级 = 轻度，3级 = 中度，4级 = 重度。基于这些数据得出2个汇总统计量：任一椎体水平的最大骨赘分级（MAX），以及各个椎体水平骨赘分级的总和（TOT）。
总共研究了681名女性，平均年龄63.3岁，以及499名男性，平均年龄63.7岁；84%的男性和74%的女性至少有一个椎体水平的骨赘分级为1级或更高。在胸段和腰段脊柱，男性的个体分级总和（TOT）以及MAX≥2的受试者比例均高于女性，且两者均随年龄增加。两性的脊柱受累模式相似，骨赘最常出现在T9 - 10和L3。体重指数增加与胸段和腰段脊柱骨赘更频繁出现相关，尽管这种关系在胸段脊柱更强。剧烈体力活动，尤其是在年轻时，与男性的骨赘形成有关。自我报告的既往和过去一年的背痛与男性的腰椎骨赘有关。
我们研究中脊柱内的分布情况以及与剧烈体力活动的关系表明机械因素在椎体骨赘形成的发病机制中很重要。需要进行前瞻性研究以探索增加椎体骨赘形成易感性的体力活动类型。在男性中，影响腰椎的骨赘与背痛有关。
