Hilliquin P, Menkès C J, Laoussadi S, Job-Deslandre C, Serratrice G
Service de Rhumatologie A, Hôpital Cochin, Paris.
Rev Rhum Mal Osteoartic. 1992 Mar;59(3):169-75.
"Camptocormism" in the elderly is an acquired kyphosis which increases during walking and is totally reducible in dorsal horizontal position in two thirds of cases. The authors report 16 cases of camptocormism in patients with a mean age of 76 (12 women, 4 men). Camptocormism was accompanied in 5 cases by an extrapyramidal syndrome, in 3 cases by articular chondrocalcinosis, in 1 case by giant cell arteritis and in 1 by rheumatoid arthritis. There was no inflammatory syndrome and muscle enzymes were raised in only 4 cases. Electromyogram of the paravertebral muscles was pathological in 5 cases, with neurogenic changes in 4 cases and a myogenic type tracing in one. CT scan or magnetic resonance imaging showed evidence in all cases of atrophy with fatty involution of the paravertebral muscles. Biopsies of the paravertebral muscles revealed moderate mononuclear cell infiltrates in 4 cases with similar abnormalities in peripheral muscles. Corticosteroids had a beneficial effect in 11 cases out of 13 and the most prolonged results were seen after bolus doses of methylprednisolone. These findings suggest that camptocormism in the elderly could be linked to inadequacy of the paravertebral muscles or, in certain cases, to interstitial myositis.
老年人的“弯腰驼背症”是一种后天性脊柱后凸，在行走时加重，三分之二的病例在背部水平位时可完全恢复。作者报告了16例弯腰驼背症患者，平均年龄76岁（12名女性，4名男性）。5例弯腰驼背症伴有锥体外系综合征，3例伴有关节软骨钙质沉着症，1例伴有巨细胞动脉炎，1例伴有类风湿性关节炎。无炎症综合征，仅4例肌酶升高。5例椎旁肌肌电图异常，4例为神经源性改变，1例为肌源性改变。CT扫描或磁共振成像显示所有病例均有椎旁肌萎缩伴脂肪化生。椎旁肌活检显示4例有中度单核细胞浸润，外周肌也有类似异常。13例中有11例使用皮质类固醇有有益效果，大剂量甲基强的松龙给药后效果最为持久。这些发现表明，老年人的弯腰驼背症可能与椎旁肌功能不全有关，或在某些情况下与间质性肌炎有关。
