Lotan Raphael, Oron Amir, Anekstein Yoram, Shalmon Ehud, Mirovsky Yigal
Spine Unit, Assaf Harofeh Medical Center, Zerifin, Israel.
J Spinal Disord Tech. 2008 Jun;21(4):247-51. doi: 10.1097/BSD.0b013e31813707af.
A retrospective study of spinal stenosis patients admitted to Assaf Harofeh Medical Center Orthopedic Departments.
To assess any correlation between systemic disease and spinal stenosis.
Lumbar stenosis is a common spinal disease with various etiologies. No findings have been reported correlating spinal stenosis incidence with background diseases, although diabetes mellitus (DM) has been found to play a role in intervertebral disc degeneration and spondylolisthesis.
Hospitalization records of patients with spinal stenosis admitted to Assaf Harofeh Medical Center Orthopedic Departments between 1984 and 1993 were checked for background diseases, age, and sex. The data collected were statistically evaluated for any correlation between spinal stenosis and chronic diseases and compared with the data published by the "Israeli Bureau of Statistics" and Israel's largest Health Maintenance Organization's chronic disease survey.
Of 537 patients with spinal stenosis 57% (308) were males and (229) 43% females with an average age of 60+/-14 years. Diseases occurring with a high incidence were hypertension (HTN)-23.2% (compared with 7.8% in the general population), DM-13.6% (5.9%), ischemic heart disease (IHD)-11.9%, and hyperlipidemia-4.4%. Patients with spinal stenosis had no significant age and sex distribution difference compared with the general population and no such difference was found for patients suffering from HTN, IHD, or DM. Isolating the effect of DM on HTN and IHD revealed that HTN was a primary disease whereas IHD was secondary to DM with significant statistical validation (P=0.003).
To the best of our knowledge this is the first study linking spinal stenosis and DM or HTN. It was found that chronic diseases do not alter the natural age and sex distribution of spinal stenosis. The major question remaining concerns the biologic mechanism linking spinal stenosis and DM or HTN.
对入住阿萨夫·哈罗费医疗中心骨科的脊柱狭窄患者进行回顾性研究。
评估全身性疾病与脊柱狭窄之间的相关性。
腰椎管狭窄是一种病因多样的常见脊柱疾病。尽管已发现糖尿病（DM）在椎间盘退变和椎体滑脱中起作用，但尚未有报道表明脊柱狭窄发病率与基础疾病之间存在关联。
查阅1984年至1993年间入住阿萨夫·哈罗费医疗中心骨科的脊柱狭窄患者的住院记录，了解其基础疾病、年龄和性别。对收集的数据进行统计学评估，以确定脊柱狭窄与慢性疾病之间的任何相关性，并与“以色列统计局”和以色列最大的健康维护组织发布的慢性病调查数据进行比较。
537例脊柱狭窄患者中，57%（308例）为男性，43%（229例）为女性，平均年龄为60±14岁。发病率较高的疾病有高血压（HTN）-23.2%（普通人群为7.8%）、糖尿病-13.6%（5.9%）、缺血性心脏病（IHD）-11.9%和高脂血症-4.4%。与普通人群相比，脊柱狭窄患者的年龄和性别分布无显著差异，患有高血压、缺血性心脏病或糖尿病的患者也无此差异。将糖尿病对高血压和缺血性心脏病的影响分离出来后发现，高血压是原发性疾病，而缺血性心脏病继发于糖尿病，具有显著的统计学验证（P=0.003）。
据我们所知，这是第一项将脊柱狭窄与糖尿病或高血压联系起来的研究。研究发现，慢性疾病不会改变脊柱狭窄的自然年龄和性别分布。剩下的主要问题是脊柱狭窄与糖尿病或高血压之间的生物学机制。
