Langlois Sandrine, Cedoz Jean Pierre, Lohse Anne, Toussirot Eric, Wendling Daniel
Service de Rhumatologie, Hôpital Jean Minjoz, CHU, Boulevard Fleming, 25030 Besançon cedex, France.
Joint Bone Spine. 2005 May;72(3):248-53. doi: 10.1016/j.jbspin.2004.05.015.
To determine whether patients with ankylosing spondylitis (AS) and discitis exhibit specific characteristics as compared to patients who have AS without discitis.
We retrospectively collected clinical, laboratory, and imaging data from the charts of 79 patients with AS admitted to a rheumatology department.
Of the 79 patients, 14 (18%) had discitis that was not due to infection or trauma. Mean age at the diagnosis of AS was 40 years and mean duration of AS at admission was 10 years, with no difference between the two groups. In three patients, discitis was the inaugural manifestation of AS. Two patients had discitis at two levels. The lumbar and thoracolumbar segments were the most common sites of discitis. Symptoms of discitis were present in 10 of the 14 patients. Stage III sacroiliitis was significantly more common in the patients with discitis. None of the patients experienced neurological compromise.
The frequency of aseptic discitis in patients with AS is probably overestimated as a result of inclusion and exclusion biases. Discitis usually occurs at an advanced stage of AS under the form of an erosive condition related to both mechanical factors and osteoporosis. Inaugural or early discitis can occur, however, as a result of the inflammatory process.
确定与无椎间盘炎的强直性脊柱炎（AS）患者相比，患有AS和椎间盘炎的患者是否具有特定特征。
我们回顾性收集了79名入住风湿科的AS患者病历中的临床、实验室和影像学数据。
79名患者中，14名（18%）患有非感染或创伤性椎间盘炎。AS诊断时的平均年龄为40岁，入院时AS的平均病程为10年，两组之间无差异。3例患者中，椎间盘炎是AS的首发表现。2例患者有两个节段的椎间盘炎。腰椎和胸腰段是椎间盘炎最常见的部位。14例患者中有10例出现椎间盘炎症状。III期骶髂关节炎在患有椎间盘炎的患者中明显更常见。所有患者均未出现神经功能损害。
由于纳入和排除偏倚，AS患者无菌性椎间盘炎的发生率可能被高估。椎间盘炎通常发生在AS的晚期，表现为与机械因素和骨质疏松相关的侵蚀性病变。然而，由于炎症过程，首发或早期椎间盘炎也可能发生。
