Klaassen Zachary, Tubbs R Shane, Apaydin Nihal, Hage Robert, Jordan Robert, Loukas Marios
Department of Anatomical Sciences, School of Medicine, St. George's University, Grenada, West Indies.
Anat Sci Int. 2011 Mar;86(1):1-9. doi: 10.1007/s12565-010-0080-8. Epub 2010 Apr 10.
Osteoarthritis is a common complication in the elderly and is often associated with osteophyte growth on vertebral bodies. The clinical presentation of vertebral osteophytes is related to anatomical structures adjacent to the spinal column. For instance, cervical osteophytes potentially involve the pharynx and esophagus, leading to dysphagic symptoms that may be accompanied by food aspiration, vocal fold paralysis and obstructive sleep apnea. In addition to anterior cervical osteophytes, posterior and uncinate process osteophytes may form, compressing the spinal cord and vertebral artery blood supply, respectively. Cervical osteophytes have also been shown to form an accessory median atlanto-occipital joint when the relationship between the atlas, dens and basiocciput is involved. In the thorax, the esophagus is often affected by osteophytes and may result in dysphagia. Traumatic and non-traumatic thoracic aorta pseudoaneurysm formation has been attributed to sharp osteophytes lacerating the aorta, a direct complication of the relationship between the aorta anterior vertebral column. Additionally, aspiration pneumonia was reported in patients with compression of a main stem bronchus, due to mechanical compression by thoracic osteophytes. In the lumbar spinal region, the two major structures in close proximity to the spine are the inferior vena cava and abdominal aorta, both of which have been reported to be affected by osteophytes. Treatment of osteophytes is initially conservative with anti-inflammatory medications, followed by surgical removal. Increasing obesity and geriatric populations will continue to result in an array of osteoarthritic degenerative changes such as osteophyte formation.
骨关节炎是老年人常见的并发症，常与椎体骨赘生长有关。椎体骨赘的临床表现与脊柱相邻的解剖结构有关。例如，颈椎骨赘可能累及咽部和食管，导致吞咽困难症状，可能伴有食物误吸、声带麻痹和阻塞性睡眠呼吸暂停。除了颈椎前缘骨赘外，还可能形成后缘和钩突骨赘，分别压迫脊髓和椎动脉供血。当寰椎、齿突和枕骨基底部之间的关系受累时，颈椎骨赘还可形成一个副正中寰枕关节。在胸部，食管常受骨赘影响，可导致吞咽困难。创伤性和非创伤性胸主动脉假性动脉瘤的形成归因于尖锐的骨赘撕裂主动脉，这是主动脉与脊柱前缘关系的直接并发症。此外，有报道称，由于胸椎骨赘的机械压迫，主支气管受压的患者会发生吸入性肺炎。在腰椎区域，与脊柱紧邻的两个主要结构是下腔静脉和腹主动脉，据报道这两个结构均会受到骨赘影响。骨赘的治疗最初采用抗炎药物进行保守治疗，随后进行手术切除。肥胖率上升和老年人口增加将继续导致一系列骨关节炎性退行性改变，如骨赘形成。
