Hawellek Thelonius, Hubert Jan, Hischke Sandra, Rolvien Tim, Krause Matthias, Püschel Klaus, Rüther Wolfgang, Niemeier Andreas
Department of Orthopaedics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
J Orthop Res. 2017 Dec;35(12):2692-2699. doi: 10.1002/jor.23591. Epub 2017 May 18.
Cartilage calcification (CC) is associated with degeneration in non-vertebral joints, but little is known about CC and lumbar vertebral joints. The goal of this study was to analyze the prevalence of CC in lumbar facet joints (FJ) and intervertebral discs (IVD) and its relation to cartilage degeneration and age in a non-selected cohort of the general population. The segment L4/5 of 85 consecutive donors (mean age 61.9 years) was analyzed by high-resolution imaging digital-contact radiography (DCR). Quantification was achieved by measuring CC in % of total cartilage area. Histological degeneration of FJs and IVDs was determined by OARSI and Boos scores. Prevalence of CC was 36.5% for FJ (95%CI (0.26, 0.48)) and 100% for IVD (95%CI (0.96, 1.00)). The amount of IVD CC (3.36% SD ± 7.14) was 16.3 times higher (p < 0.001) than that of the FJ (0.23% SD ± 0.53) and independent of each other (p = 0.07). The amount of FJ CC correlated significantly with FJ and IVD degeneration (FJ r = 0.44, p = 0.01, IVD r = 0.49, p = 0.006) while the amount of IVD CC correlated only with IVD degeneration (r = 0.54, p < 0.001). Age correlated with IVD CC (r = 0.35, p < 0.001), but not FJ CC (r = 0.04, p = 0.85). We conclude that IVD fibrocartilage is particularly prone to calcification. A causal relationship between lumbar CC and degeneration is possible, but the clear differences in IVD fibrocartilage CC and FJ synovial joint CC in regard to prevalence and in relation to age point to a differential role of CC in single compartments of the respective motion segment in lumbar spine degeneration. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:2692-2699, 2017.
软骨钙化(CC)与非脊柱关节的退变相关,但关于CC与腰椎关节的情况却知之甚少。本研究的目的是分析普通人群中未经过筛选的队列里腰椎小关节(FJ)和椎间盘(IVD)中CC的患病率及其与软骨退变和年龄的关系。通过高分辨率成像数字接触式放射摄影(DCR)对85例连续捐赠者(平均年龄61.9岁)的L4/5节段进行分析。通过测量CC占总软骨面积的百分比来实现定量分析。FJ和IVD的组织学退变通过骨关节炎研究学会(OARSI)和布氏(Boos)评分来确定。FJ的CC患病率为36.5%(95%置信区间(0.26, 0.48)),IVD的CC患病率为100%(95%置信区间(0.96, 1.00))。IVD的CC量(3.36%标准差±7.14)比FJ的CC量(0.23%标准差±0.53)高16.3倍(p < 0.001),且两者相互独立(p = 0.07)。FJ的CC量与FJ和IVD的退变显著相关(FJ:r = 0.44,p = 0.01;IVD:r = 0.49,p = 0.006),而IVD的CC量仅与IVD的退变相关(r = 0.54,p < 0.001)。年龄与IVD的CC相关(r = 0.35,p < 0.001),但与FJ的CC无关(r = 0.04,p = 0.85)。我们得出结论,IVD纤维软骨特别容易发生钙化。腰椎CC与退变之间可能存在因果关系,但IVD纤维软骨CC和FJ滑膜关节CC在患病率以及与年龄关系方面的明显差异表明,CC在腰椎退变各运动节段的单个腔室中具有不同作用。© 2017骨科学研究学会。由威利期刊公司出版。《矫形外科学研究杂志》35:2692 - 2699,2017年。