Department of Orthopaedic and Trauma Surgery, Campus Biomedico University, Via Alvaro del Portillo, 200, 00128 Rome, Italy.
Eur Spine J. 2011 Oct;20(10):1658-62. doi: 10.1007/s00586-011-1737-2. Epub 2011 Mar 9.
Insufficient blood supply to the intervertebral disc (IVD) has been proposed to play a role as causative factor in IVD degeneration. There is an association between IVD diseases and increased risk of dying of ischaemic heart disease. Obesity and tobacco are potential risk factors for degenerative IVD disease. High blood cholesterol and triglycerides serum levels are risk factors for atherosclerosis, and could be responsible for a decreased in the blood supply to the already poor vascularized IVD. We performed a frequency-matched case-control study to determine the serum levels of patients with symptomatic herniated lumbar disc. We examined the fasting serum lipid levels in 384 subjects who were operated at our institution. Group 1 included 169 consecutive patients (115 men and 54 women; mean age: 59.1 years, range 29-85) who underwent surgery for symptomatic disc herniation. Group 2 (control group) included 169 patients (115 men and 54 women; mean age: 61 years, range 26-86) who underwent arthroscopic meniscectomy for a meniscal tear in the same period. These patients were frequency-matched by age (within 3 years) and gender with patients of Group 1. Sera were extracted from blood samples and the concentrations of total cholesterol (TC) and triglycerides (TG) were determined. When comparing the two groups, patients with symptomatic herniated lumbar disc showed statistically significant higher triglyceride concentration (P = 0.02) and total cholesterol concentration (P = 0.01). Serum lipid levels may be a risk factor for IVD pathology. An enhanced understanding of these factors holds the promise of new approaches to the prevention and management of IVD pathology.
椎间盘(IVD)的血液供应不足被认为是导致 IVD 退变的一个致病因素。IVD 疾病与缺血性心脏病死亡风险增加之间存在关联。肥胖和吸烟是退行性 IVD 疾病的潜在危险因素。高胆固醇和甘油三酯血清水平是动脉粥样硬化的危险因素,可能导致已经血管化不良的 IVD 血液供应减少。我们进行了一项频率匹配的病例对照研究,以确定有症状腰椎间盘突出症患者的血清水平。我们检查了在我们机构接受手术的 384 名受试者的空腹血脂水平。第 1 组包括 169 例连续患者(115 名男性和 54 名女性;平均年龄:59.1 岁,范围 29-85 岁),他们因有症状的椎间盘突出症接受了手术。第 2 组(对照组)包括 169 例患者(115 名男性和 54 名女性;平均年龄:61 岁,范围 26-86 岁),他们在同一时期因半月板撕裂接受了关节镜半月板切除术。这些患者通过年龄(3 年内)和性别与第 1 组的患者进行了频率匹配。从血液样本中提取血清,并测定总胆固醇(TC)和甘油三酯(TG)的浓度。在比较两组时,有症状的腰椎间盘突出症患者的甘油三酯浓度(P = 0.02)和总胆固醇浓度(P = 0.01)均有统计学显著升高。血清脂质水平可能是 IVD 病理的一个危险因素。对这些因素的深入了解有望为预防和管理 IVD 病理提供新的方法。