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老年人群脊柱椎间盘钙化:影像学患病率、位置、分布及其与脊柱退变的相关性

Intervertebral disk calcification of the spine in an elderly population: radiographic prevalence, location, and distribution and correlation with spinal degeneration.

作者信息

Chanchairujira Kullanuch, Chung Christine B, Kim Jee Young, Papakonstantinou Olympia, Lee Min Hee, Clopton Paul, Resnick Donald

机构信息

Department of Radiology, Veterans Administration Medical Center, University of California San Diego, 3350 La Jolla Village Dr, San Diego, CA 92161, USA.

出版信息

Radiology. 2004 Feb;230(2):499-503. doi: 10.1148/radiol.2302011842.

Abstract

PURPOSE

To determine the prevalence, distribution, and location of intervertebral disk calcification (IDC) in the thoracic and lumbar spine and the association of IDC with radiographically evident spinal degenerative changes in cadavers.

MATERIALS AND METHODS

Anterior vertebral columns comprising T1 through L5 were removed from 223 cadavers (183 men, 40 women; mean age at death, 67 years; range, 37-94 years). Approximately 5-mm-thick parasagittal sections were investigated with high-contrast radiography. The presence of IDC, osteophytes, vertebral endplate abnormalities, and vacuum phenomena was recorded, and the height of disk space was measured at 3,568 intervertebral levels. Logistic regression analysis was performed.

RESULTS

IDC was identified in 178 (80%) of the 223 cadavers. Of 3,568 disks, 459 (13%) had IDC, and 289 cases (63%) were located in the annulus fibrosus. IDC was most common in the lower thoracic spine, occurring in 275 (60%) of 459 disks. IDC occurred in 159 (87%) of 183 men and 19 (48%) of 40 women. Logistic regression analysis was adjusted for age, and results showed that the frequency of IDC was significantly higher in men in upper, middle, and lower segments of the thoracic spine (P <.05) but not in the lumbar spine (P =.09). IDC correlated with increasing age (P <.001) and disk space loss (P <.001) at all spinal levels. There was no association of IDC with vacuum phenomena or vertebral endplate abnormalities at any spinal level.

CONCLUSION

IDC is common in elderly persons, especially in the annulus fibrosus and lower thoracic spine. The prevalence of IDC increases with age and extent of disk space loss.

摘要

目的

确定胸腰椎椎间盘钙化(IDC)的患病率、分布及位置,以及尸体中IDC与影像学上明显的脊柱退行性改变之间的关联。

材料与方法

从223具尸体(183名男性,40名女性;平均死亡年龄67岁;范围37 - 94岁)中取出包含T1至L5的前柱椎体。用高对比度X线摄影对约5毫米厚的矢状旁切面进行研究。记录IDC、骨赘、椎体终板异常及真空现象的存在情况,并在3568个椎间水平测量椎间盘间隙高度。进行逻辑回归分析。

结果

在223具尸体中的178具(80%)发现了IDC。在3568个椎间盘中,459个(13%)有IDC,289例(63%)位于纤维环。IDC在胸段脊柱下部最常见,在459个椎间盘中的275个(60%)出现。183名男性中有159名(87%)出现IDC,40名女性中有19名(48%)出现。逻辑回归分析对年龄进行了校正,结果显示胸段脊柱上、中、下节段男性的IDC发生率显著更高(P <.05),但腰椎则不然(P =.09)。在所有脊柱节段,IDC与年龄增长(P <.001)和椎间盘间隙变窄(P <.001)相关。在任何脊柱节段,IDC与真空现象或椎体终板异常均无关联。

结论

IDC在老年人中很常见,尤其是在纤维环和胸段脊柱下部。IDC的患病率随年龄增长和椎间盘间隙变窄程度而增加。

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