基于计算机断层扫描的横断面研究：胸段黄韧带骨化的流行情况及其相关临床因素。
Prevalence and related clinical factors of thoracic ossification of the ligamentum flavum-a computed tomography-based cross-sectional study.
机构信息
Department of Orthopedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
Department of Orthopedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
出版信息
Spine J. 2018 Apr;18(4):551-557. doi: 10.1016/j.spinee.2017.08.240. Epub 2017 Aug 17.
BACKGROUND TEXT
Thoracic ossification of the ligamentum flavum (TOLF) is an uncommon pathology, but it may sometimes grow and cause serious neurologic manifestations. Little has been demonstrated yet about the epidemiology and etiology of TOLF.
PURPOSE
This study aimed to estimate the prevalence and clinical characteristics of TOLF.
DESIGN
A cross-sectional study was carried out.
PATIENT SAMPLE
All individuals who had undergone chest computed tomography (CT) for the evaluation of pulmonary disease or for medical examination for 1 year at our institute comprised the patient sample.
OUTCOME MEASURES
Presence of TOLF and the association of these findings with thoracic kyphosis (TK), ossification of posterior longitudinal ligament (OPLL), space available for cord (SAC), age, gender, body mass index (BMI), and diabetes were the outcome measures.
METHODS
Prevalence and distribution of TOLF, TK, and concurrent OPLL were analyzed on CT scans. Through reviews of their medical records, clinical characteristics including age, gender, BMI, and diabetes were investigated. Logistic regression analysis was performed to determine the risk factors of TOLF.
RESULTS
A total of 4,999 individuals (2,929 men and 2,070 women) were included for the analysis. Thoracic ossification of the ligamentum flavum was found in 1,090 individuals (674 men and 416 women. A single TOLF lesion was noted in 592 individuals and multiple lesions were noted in 498 individuals. The most commonly involved level was T10-T11. Distribution of TOLF showed two peaks: and the highest peak was at the lower thoracic spine (T10-12) and the second highest peak was at T3-T5. Thoracic kyphosis was 31.5°±9.5° in the TOLF group and 29.7°±8.9° in the non-TOLF group (p<.001). Space available for cord/anteroposterior canal diameter ratio in TOLF level was 0.882. Logistic regression analysis showed that gender and TK were significantly associated with TOLF.
CONCLUSIONS
Incidental TOLF was found in 21.8% of the study cohort. Gender and TK were related to TOLF.
背景文本
胸段黄韧带骨化（TOLF）是一种不常见的病理学，但它有时会生长并导致严重的神经表现。目前关于 TOLF 的流行病学和病因学还知之甚少。
目的
本研究旨在评估 TOLF 的患病率和临床特征。
设计
进行了一项横断面研究。
患者样本
本研究所进行的胸部计算机断层扫描（CT）评估肺部疾病或医疗检查的所有个体均构成患者样本。
观察指标
存在 TOLF 以及这些发现与胸椎后凸（TK）、后纵韧带骨化（OPLL）、脊髓可用空间（SAC）、年龄、性别、体重指数（BMI）和糖尿病的关联是观察指标。
方法
在 CT 扫描上分析 TOLF、TK 和并发 OPLL 的患病率和分布。通过查阅病历，调查了年龄、性别、BMI 和糖尿病等临床特征。进行逻辑回归分析以确定 TOLF 的危险因素。
结果
共纳入 4999 人（2929 名男性和 2070 名女性）进行分析。1090 人（674 名男性和 416 名女性）发现胸段黄韧带骨化。592 人存在单个 TOLF 病变，498 人存在多个病变。最常受累的水平是 T10-T11。TOLF 的分布呈双峰分布：最高峰位于下胸椎（T10-12），第二高峰位于 T3-T5。TOLF 组的胸椎后凸为 31.5°±9.5°，非 TOLF 组为 29.7°±8.9°（p<.001）。TOLF 水平的脊髓可用空间/前后径比为 0.882。逻辑回归分析显示，性别和 TK 与 TOLF 显著相关。
结论
研究队列中偶然发现 TOLF 占 21.8%。性别和 TK 与 TOLF 相关。
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