Rehart S, Pfister A, Kerschbaumer F
Klinik für Orthopädie und Unfallchirurgie, Markus-Krankenhaus, Akademisches Lehrkrankenhaus, Wihelm-Epstein-Str. 2, 60431 Frankfurt.
Orthopade. 2007 Aug;36(8):735-8. doi: 10.1007/s00132-007-1129-9.
In rheumatoid arthritis the anatomical structures of the lumbar spine are affected by the same mechanisms of destruction as are known from other skeletal regions. Although spinal symptoms do not become apparent until the later stages of rheumatoid arthritis, patients do sometimes complain of typical symptoms. We present data recorded in 19 patients with seropositive rheumatoid arthritis who underwent hospital treatment directed exclusively at isolated low-back pain. The patients were questioned in some detail with the aid of instruments including the Oswestry, TypE, HAQ and RADAI questionnaires and a visual-analogue-pain scale. Roentgen exposures were also evaluated. A comparison was drawn between patients treated surgically with decompression and various spondylodeses (n=13) and those who received conservative treatment (n=6). Better results were obtained in the group of patients treated surgically, though a statistical evaluation was not possible. No histological evidence of rheumatoid alterations was found in the intervertebral disc tissue samples available.
在类风湿性关节炎中，腰椎的解剖结构受与其他骨骼区域已知的相同破坏机制影响。尽管脊柱症状直到类风湿性关节炎后期才会明显，但患者有时确实会抱怨典型症状。我们呈现了19例血清阳性类风湿性关节炎患者的数据，这些患者接受了专门针对孤立性下背痛的住院治疗。借助包括奥斯维斯特里（Oswestry）、TypE、健康评估问卷（HAQ）和类风湿性关节炎疾病活动指数（RADAI）问卷以及视觉模拟疼痛量表等工具，对患者进行了较为详细的询问。还对X线检查结果进行了评估。对接受减压和各种脊柱融合手术治疗的患者（n = 13）与接受保守治疗的患者（n = 6）进行了比较。手术治疗组取得了更好的结果，不过无法进行统计学评估。在所获得的椎间盘组织样本中未发现类风湿性改变的组织学证据。
