de Vlam K, Mielants H, Veys E M
Department of Rheumatology, University Hospital Gent, Belgium.
J Rheumatol. 1999 Aug;26(8):1738-45.
To determine the prevalence of zygapophyseal (ZA) joint ankylosis in ankylosing spondylitis (AS) and the relation of this ankylosis to the presence of bridging syndesmophytes.
Roentgenograms of the cervical and lumbar spine of 50 patients with AS were scored by a vertebral body score according to Taylor and a newly developed score for ZA joint involvement.
At the cervical level 22% of the ZA joints were ankylosed and 16% of the levels presented bridging syndesmophytes. In the lumbar spine 22% of ZA joints were ankylosed and 16% of the vertebral levels showed ankylosis in both ZA joints. Bridging syndesmophytes were present in 11% of the vertebral levels. Ankylosis of the ZA joints and bridging syndesmophytes were seen simultaneously in 14% of the cervical levels and in 9% of all lumbar levels. Ankylosed ZA joints were present in 21% of the lumbar levels without bridging syndesmophytes and in 8% of the cervical levels without bridging syndesmophytes. Bridging syndesmophytes at a given level without ankylosis of the respective ZA joint were uncommon: 4 of 201 lumbar levels and 4 of 238 cervical levels. Ankylosis of the ZA joint and presence of bridging syndesmophytes is markedly associated, but in a discordant way.
The ZA joint is affected in a major way in AS. Involvement of the ZA joint and the presence of syndesmophytes are related. An asymmetric relation suggests that the ZA joint is primarily involved in AS.
确定强直性脊柱炎（AS）中关节突关节（ZA）融合的患病率，以及这种融合与桥接韧带骨赘存在的关系。
根据泰勒椎体评分法和新制定的ZA关节受累评分法，对50例AS患者的颈椎和腰椎X线片进行评分。
在颈椎水平，22%的ZA关节发生融合，16%的节段出现桥接韧带骨赘。在腰椎，22%的ZA关节发生融合，16%的椎体节段显示双侧ZA关节融合。11%的椎体节段存在桥接韧带骨赘。在14%的颈椎节段和9%的所有腰椎节段中，同时出现ZA关节融合和桥接韧带骨赘。在无桥接韧带骨赘的腰椎节段中，21%存在ZA关节融合；在无桥接韧带骨赘的颈椎节段中，8%存在ZA关节融合。在给定节段出现桥接韧带骨赘而相应ZA关节未融合的情况并不常见：201个腰椎节段中有4个，238个颈椎节段中有4个。ZA关节融合与桥接韧带骨赘的存在显著相关，但方式不一致。
在AS中，ZA关节受到严重影响。ZA关节受累与韧带骨赘的存在有关。不对称关系表明ZA关节在AS中起主要作用。
