Bajwa Navkirat S, Toy Jason O, Young Ernest Y, Cooperman Daniel R, Ahn Nicholas U
Research Medical Student, Department of Orthopaedics, University Hospitals, Case Western Reserve University, Cleveland, Ohio.
Am J Orthop (Belle Mead NJ). 2013 Jul;42(7):309-12.
It is not clear whether spinal degeneration leads to hip arthritis, or hip arthritis leads to spinal degeneration. We conducted a study to determine which degenerative process precedes the other. We examined 340 cadaveric human specimens from the Hamann-Todd Osteological Collection (Cleveland, Ohio). Lumbar endplate degeneration was graded on a scale of 0 to 4, and hip degeneration on a scale of 0 to 3. Linear regression was used to analyze the relationship between hip osteoarthritis (OA) and lumbar degenerative disk disease (DDD). Exact tests were used to identify differences in each age group. Hip OA was significantly associated with endplate degeneration at the L1, L3, and L5 levels (P<.02). Of the specimens younger than 29 years, 35% had evidence of DDD in at least 1 lumbar level, and 17% of hip OA changes. At 70 years, 100% of the specimens had evidence of DDD and 50% of hip OA changes. There was a significant association between lumbar DDD and hip OA changes (P<.05). Early lumbar DDD was twice as common as hip OA changes in the early 20s age range. These findings suggest that lumbar degeneration precedes hip degeneration and may be a causative factor for hip OA.
目前尚不清楚是脊柱退变导致髋关节炎，还是髋关节炎导致脊柱退变。我们开展了一项研究以确定哪种退变过程先于另一种。我们检查了来自哈曼 - 托德骨学收藏馆（俄亥俄州克利夫兰）的340份人体尸体标本。腰椎终板退变按0至4级分级，髋部退变按0至3级分级。采用线性回归分析髋骨关节炎（OA）与腰椎间盘退变疾病（DDD）之间的关系。使用精确检验来确定各年龄组之间的差异。髋OA与L1、L3和L5水平的终板退变显著相关（P<0.02）。在年龄小于29岁的标本中，35%在至少1个腰椎水平有DDD证据，17%有髋OA改变。在70岁时，100%的标本有DDD证据，50%有髋OA改变。腰椎DDD与髋OA改变之间存在显著关联（P<0.05）。在20岁出头的年龄范围内，早期腰椎DDD的发生率是髋OA改变的两倍。这些发现表明腰椎退变先于髋部退变，可能是髋OA的一个致病因素。
