Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimidera, Wakayama, Wakayama, 641-8509, Japan.
Department of Joint Disease Research, Faculty of Medicine, 22nd Century Medical and Research Center, The University of Tokyo, Tokyo, Japan.
Eur Spine J. 2017 Oct;26(10):2529-2535. doi: 10.1007/s00586-017-5072-0. Epub 2017 Apr 3.
Tandem spinal stenosis (TSS) is a condition of combined spinal stenosis in the cervical and lumbar regions. The purpose of this study was to determine the prevalence of radiographic TSS and its association with developmental canal stenosis (DCS). The second purpose was to investigate the extent to which radiographic TSS is associated with cervical myelopathy and symptomatic LSS.
We recruited 1011 (336 men and 675 women) participants in this population-based study. After excluding those with a pacemaker, a history of cervical or lumbar surgery, disqualification, the MRI data of whole spine was analysed in 931 (mean, 67.3 years) participants. Cervical cord compression (CCC) and radiographic lumbar spinal stenosis (LSS) were evaluated by MRI. The canal-to-body ratio was also measured by plain X-ray. DCS was diagnosed as canal-to-body ratio <0.75. The diagnosis of cervical myelopathy and symptomatic LSS was made by presentation of both symptoms and radiographic compression using MRI.
The prevalence of CCC was 24.7%, that of radiographic LSS was 30.2%, and that of radiographic TSS was 11.0% (men, 14.1%; women, 9.4%). The prevalence of TSS was significantly higher in the DCS group than in the non-DCS group (p < 0.001). Among the participants with radiographic TSS, the prevalence of cervical myelopathy and symptomatic LSS was 9.8 and 18.6%, respectively. The coexisting cervical myelopathy and symptomatic LSS was 6.1% in the participants with LSS.
The present study is the first population-based study to clarify TSS characteristic using whole-spine MRI.
串联性椎管狭窄（TSS）是颈椎和腰椎同时发生椎管狭窄的一种情况。本研究旨在确定影像学 TSS 的患病率及其与发育性管腔狭窄（DCS）的关系。第二个目的是调查影像学 TSS 与颈椎脊髓病和症状性腰椎管狭窄症（LSS）的关联程度。
我们在这项基于人群的研究中招募了 1011 名参与者（336 名男性和 675 名女性）。排除了装有起搏器、有颈椎或腰椎手术史、不合格的参与者后，我们对 931 名（平均年龄 67.3 岁）参与者的全脊柱 MRI 数据进行了分析。通过 MRI 评估颈椎脊髓压迫（CCC）和影像学腰椎椎管狭窄（LSS）。椎管与椎体比值也通过平片 X 射线测量。DCS 诊断为椎管与椎体比值<0.75。颈椎脊髓病和症状性 LSS 的诊断是根据 MRI 显示的症状和影像学压迫来做出的。
CCC 的患病率为 24.7%，影像学 LSS 的患病率为 30.2%，影像学 TSS 的患病率为 11.0%（男性为 14.1%，女性为 9.4%）。DCS 组 TSS 的患病率明显高于非 DCS 组（p<0.001）。在有影像学 TSS 的参与者中，颈椎脊髓病和症状性 LSS 的患病率分别为 9.8%和 18.6%。在有 LSS 的参与者中，同时存在颈椎脊髓病和症状性 LSS 的比例为 6.1%。
本研究是首次使用全脊柱 MRI 阐明 TSS 特征的基于人群的研究。
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