腰椎间盘退变：骨赘、终板硬化与椎间盘间隙变窄之间的关联
Lumbar disc degeneration: association between osteophytes, end-plate sclerosis and disc space narrowing.
作者信息
Pye Stephen R, Reid David M, Lunt Mark, Adams Judith E, Silman Alan J, O'Neill Terence W
机构信息
arc Epidemiology Unit, The University of Manchester, Oxford Road, Manchester M13 9PT, UK.
出版信息
Ann Rheum Dis. 2007 Mar;66(3):330-3. doi: 10.1136/ard.2006.052522. Epub 2006 Oct 6.
BACKGROUND
Lumbar disc degeneration is characterised radiologically by the presence of osteophytes, end-plate sclerosis and disc space narrowing.
AIM
To determine the strength of the association between increasing severity of combinations of these features in a population sample of men and women.
METHODS
Men and women aged >or=50 years were recruited from a primary care-based community health index in Aberdeen, UK. Participants had lateral spinal radiographs performed according to a standard protocol. The intervertebral disc spaces (L1/2-L4/5) were evaluated for the presence of anterior osteophytes, end-plate sclerosis and disc space narrowing using a graded semiquantitative score (grade 0-3). Log linear modelling was used to determine the associations (pairwise) between increasing severity of these features, with the results expressed as beta coefficients and 95% confidence intervals (CIs).
RESULTS
There were 286 men (mean age 65.3 years) and 299 women (mean age 65.2 years) with spinal radiographs, yielding a total of 2340 assessable lumbar vertebral levels. In all, 73% of vertebral levels had evidence of osteophytes, 26% of sclerosis and 37% of disc space narrowing. Increasing severity of osteophyte grade was associated with an increasing severity both of sclerosis and of disc space narrowing, whereas the severity of sclerosis was associated with the severity of narrowing. This was true at all vertebral levels. The strongest association, however, was between osteophytes and sclerosis (beta coefficient = 2.7, 95% CI 2.4 to 3.1). For sclerosis and narrowing the beta coefficient was 1.9 (95% CI 1.7 to 2.1), whereas for osteophytes and narrowing the beta coefficient was much weaker at 1.2 (95% CI 1.1 to 1.3). There was no important influence of vertebral level on any of these associations.
CONCLUSION
The association between increasing severity of osteophytes and end-plate sclerosis is stronger than for other combinations of radiographic features of lumbar disc degeneration.
背景
腰椎间盘退变在影像学上的特征为骨赘形成、终板硬化和椎间隙狭窄。
目的
确定在男性和女性人群样本中，这些特征组合的严重程度增加之间的关联强度。
方法
从英国阿伯丁基于初级保健的社区健康指数中招募年龄≥50岁的男性和女性。参与者按照标准方案进行脊柱侧位X线摄影。使用分级半定量评分（0 - 3级）评估腰椎间盘间隙（L1/2 - L4/5）是否存在前缘骨赘、终板硬化和椎间隙狭窄。采用对数线性模型确定这些特征严重程度增加之间的关联（两两比较），结果以β系数和95%置信区间（CI）表示。
结果
有286名男性（平均年龄65.3岁）和299名女性（平均年龄65.2岁）进行了脊柱X线摄影，共获得2340个可评估的腰椎椎体节段。总体而言，73%的椎体节段有骨赘证据，26%有硬化，37%有椎间隙狭窄。骨赘分级严重程度增加与硬化和椎间隙狭窄严重程度增加均相关，而硬化严重程度与狭窄严重程度相关。在所有椎体节段均如此。然而，最强的关联存在于骨赘和硬化之间（β系数 = 2.7，95% CI 2.4至3.1）。对于硬化和狭窄，β系数为1.9（95% CI 1.7至2.1），而对于骨赘和狭窄，β系数则弱得多，为1.2（95% CI 1.1至1.3）。椎体节段对这些关联均无重要影响。
结论
骨赘严重程度增加与终板硬化之间的关联比腰椎间盘退变其他影像学特征组合的关联更强。
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