中国人种脊柱韧带骨化的流行病学及相关因素：2000 例连续个体的横断面研究。

Epidemiology of ossification of the spinal ligaments and associated factors in the Chinese population: a cross-sectional study of 2000 consecutive individuals.

机构信息

Department of Orthopedic Surgery, Zhongshan Hospital, Fudan University, Building 1, 180 Fenglin Road, Shanghai, 200032, People's Republic of China.

Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, F B1, Building 16, 180 Fenglin Road, Shanghai, 200032, People's Republic of China.

出版信息

BMC Musculoskelet Disord. 2019 May 25;20(1):253. doi: 10.1186/s12891-019-2569-1.

DOI:10.1186/s12891-019-2569-1

PMID:31128588

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6534908/

Abstract

BACKGROUND

The epidemiology and cause of ossification of the spinal ligaments (OSL) remains obscure. To date, there is no study that comprehensively evaluates the prevalence, distribution, and concomitance of each type of OSL by CT among general Chinese population. We therefore aimed to comprehensively investigate epidemiological characteristics of OSL using whole spine CT in the Chinese population and examine the factors that correlate with the presence of OSL.

METHODS

Ossification of the posterior longitudinal ligament (OPLL), ligamentum flavum (OLF), anterior longitudinal ligament (OALL), nuchal ligament (ONL), and diffuse idiopathic skeletal hyperostosis (DISH) were evaluated from the subjects who underwent PET/CT for the purpose of cancer screening in our hospital. Prevalence, distribution, and concomitance of OSL were reviewed. Logistic regression analysis was performed to identify the risk factors of OSL.

RESULTS

A total of 2000 subjects (1335 men and 665 women) were included. The prevalence rate of cervical OPLL (C-OPLL) was 4.1%, thoracic OPLL (T-OPLL) 2.25%, lumbar OPLL (L-OPLL) 0.8%, thoracic OLF (T-OLF) 37.65%, lumbar OLF (L-OLF) 1.45%, ONL 31.5%, DISH 3.85%. The most commonly involved level was C5 for C-OPLL, T1 for T-OPLL, T10 for T-OLF, and T8/9 for OALL. 21% of subjects with C-OPLL had T-OPLL, 44% of C-OPLL had T-OLF, 38% of T-OPLL had C-OPLL, 53% of T-OPLL had T-OLF, 44% of L-OPLL had T-OPLL, and 56% of L-OPLL had T-OLF. The average age of OSL-positive subjects was significantly higher than that of OSL-negative subjects. The results of the multiple regression analysis revealed that males had a strong association with DISH (odds ratio, 3.15; 95% confidence interval, 1.27-7.78; P = 0.013).

CONCLUSION

The prevalence of OSL in the Chinese was revealed. Tandem ossification is not uncommon in people with OSL. There is a high incidence of multiple-regional OPLL in the whole spine. Approximately half of the subjects with OPLL coexist with T-OLF. For patients with clinical symptoms induced by OPLL, thorough evaluation of whole spine using CT is recommended.

摘要

背景

脊柱韧带骨化（OSL）的流行病学和病因仍不清楚。迄今为止，尚无研究全面评估中国人群中 CT 检查中每种类型 OSL 的患病率、分布和并存情况。因此，我们旨在通过对中国人的全脊柱 CT 全面研究 OSL 的流行病学特征，并探讨与 OSL 存在相关的因素。

方法

对因癌症筛查目的在我院行正电子发射断层扫描/计算机断层扫描（PET/CT）的患者进行回顾性分析，评估后纵韧带骨化（OPLL）、黄韧带骨化（OLF）、前纵韧带骨化（OALL）、项韧带骨化（ONL）和弥漫性特发性骨肥厚（DISH）。回顾 OSL 的患病率、分布和并存情况。采用 Logistic 回归分析识别 OSL 的危险因素。

结果

共纳入 2000 例受试者（男 1335 例，女 665 例）。颈椎 OPLL（C-OPLL）的患病率为 4.1%，胸椎 OPLL（T-OPLL）为 2.25%，腰椎 OPLL（L-OPLL）为 0.8%，胸椎 OLF（T-OLF）为 37.65%，腰椎 OLF（L-OLF）为 1.45%，ONL 为 31.5%，DISH 为 3.85%。最常见受累节段为 C5 颈椎 C-OPLL，T1 胸椎 T-OPLL，T10 胸椎 T-OLF，T8/9 胸腰椎 OALL。21%的 C-OPLL 患者有 T-OPLL，44%的 C-OPLL 患者有 T-OLF，38%的 T-OPLL 患者有 C-OPLL，53%的 T-OPLL 患者有 T-OLF，44%的 L-OPLL 患者有 T-OPLL，56%的 L-OPLL 患者有 T-OLF。OSL 阳性患者的平均年龄明显高于 OSL 阴性患者。多因素回归分析结果显示，男性与 DISH 显著相关（比值比，3.15；95%置信区间，1.27-7.78；P=0.013）。