无症状健康个体中寰枢横韧带骨化的流行率及自然病程。

Prevalence and Natural Course of Transverse Ligament of the Atlas Calcification in Asymptomatic Healthy Individuals.

机构信息

Department of Orthopedic Surgery, Faculty of Medicine, The University of Tokyo Hospital, Tokyo, Japan.

Department of Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical and Research Center, The University of Tokyo Hospital, Tokyo, Japan.

出版信息

Spine (Phila Pa 1976). 2018 Dec 15;43(24):E1469-E1473. doi: 10.1097/BRS.0000000000002744.

DOI:10.1097/BRS.0000000000002744

PMID:29901539

Abstract

STUDY DESIGN

A retrospective cross-sectional study.

OBJECTIVE

The aim of this study was to assess the prevalence and natural course of calcification of the transverse ligament of the atlas (TLA) in healthy subjects and to investigate the relationship between the calcified lesion and clinical factors.

SUMMARY OF BACKGROUND DATA

The prevalence and etiology of TLA calcification in healthy individuals remain uncertain.

METHODS

We enrolled 1136 participants undergoing computed tomography (CT) scans in their routine medical checkups. The calcified lesion of the TLA was classified into two types: type 1, thin calcifications (<2 mm) and type 2, curvilinear lesions (>2 mm). We evaluated the natural course of the lesion and compared each clinical variable among subjects with and without TLA calcifications after adjusting for age and sex using propensity score matching techniques.

RESULTS

TLA calcification was present in 40 participants (3.5%; 31 males and 9 females; mean age, 65.3 years), and the frequency increased with age (P = 0.001). Both types 1 and 2 calcifications were observed in 26 (65%) and 14 cases (35%), with mean ages of 63.0 and 69.4 years (P = 0.033), respectively. Of these, 37 (93%) underwent another medical checkup afterward, and the morphological changes were further assessed. Five cases (14%) showed enlargement [one case (4%) in type 1 vs. four cases (33%) in type 2], whereas six cases (16%) had disappearance or decrease [six cases (24%) in type 1 vs. 0 cases in type 2, which was statistically significant (P = 0.019)]. A one-to-one propensity score matching analysis revealed no significant differences in clinical variables among subjects with and without TLA calcifications.

CONCLUSION

The prevalence of the TLA calcification was not rare in normal subjects. Our results suggest that the calcified lesion could be morphologically changed on a yearly basis and may be associated with the normal aging process.

LEVEL OF EVIDENCE

摘要

研究设计

回顾性横截面研究。

目的

本研究旨在评估健康受试者中寰枢横韧带（TLA）钙化的发生率和自然病程，并探讨钙化病变与临床因素之间的关系。

背景资料概要

健康个体中 TLA 钙化的发生率和病因尚不确定。

方法

我们纳入了 1136 名在常规体检中接受计算机断层扫描（CT）检查的参与者。将 TLA 的钙化病变分为两型：1 型为薄型钙化（<2mm），2 型为曲线型病变（>2mm）。我们评估了病变的自然病程，并在调整年龄和性别后，使用倾向评分匹配技术比较了有和无 TLA 钙化的受试者之间的每个临床变量。

结果

40 名参与者（3.5%；31 名男性和 9 名女性；平均年龄 65.3 岁）存在 TLA 钙化，且频率随年龄增加而增加（P=0.001）。26 例（65%）和 14 例（35%）分别观察到 1 型和 2 型钙化，平均年龄分别为 63.0 岁和 69.4 岁（P=0.033）。其中 37 名（93%）随后接受了另一次体检，进一步评估了形态变化。5 例（14%）显示增大[1 例（4%）为 1 型，4 例（33%）为 2 型]，而 6 例（16%）显示消失或减少[6 例（24%）为 1 型，0 例为 2 型，差异具有统计学意义（P=0.019）]。1:1 倾向评分匹配分析显示，有和无 TLA 钙化的受试者之间的临床变量无显著差异。