Department of Orthopedic Surgery, Ehime University School of Medicine, Shitsukawa, Ehime, Japan.
Regional Medical Play Laboratory, Ehime University School of Medicine, Shitsukawa, Ehime, Japan.
Spine (Phila Pa 1976). 2019 Sep;44(18):E1068-E1074. doi: 10.1097/BRS.0000000000003151.
Retrospective case-control study.
To investigate the prevalence and characteristics of diffuse idiopathic skeletal hyperostosis (DISH) in vertebral fracture patients admitted to our hospital.
Although vertebral fracture is generally treated conservatively with rest and use of a corset, surgery with rigid internal fixation is recommended for vertebral fractures in patients with DISH. Thus, treatment strategies for vertebral fracture differ according to the presence or absence of DISH. However, only a few studies have investigated the prevalence of DISH in vertebral fracture patients.
A total of 159 patients (49 men and 110 women, with a mean age of 82.9 years) who were diagnosed with fresh vertebral fracture and required admission to HITO Hospital. The diagnosis of fresh vertebral fracture was made using x-ray imaging, computed tomography, and magnetic resonance imaging, and the presence or absence of DISH was assessed. In addition, age, sex, bone mineral density ( % young adult mean), blood test results, treatment, and length of hospital stay were compared between patients with and without DISH.
The proportion of patients with DISH among the patients with vertebral fracture was 33.9% (54 of 159 patients). The proportions in men and women were 38.8% and 31.8%, respectively, with no significant difference between sexes (P = 0.39). The patients in the DISH group were older than those in the non-DISH group (83.6 vs. 79.4 years, P = 0.009), and the DISH group had higher glycated hemoglobin A1c (P = 0.005), higher bone mineral density (P = 0.042), and longer length of hospital stay (P = 0.0001) compared with those in the non-DISH group.
The proportion of patients with DISH among the vertebral fracture patients was 33.9%. Given that patients with DISH may require different treatment approaches, careful observation is needed.
回顾性病例对照研究。
调查我院收治的椎体骨折患者弥漫性特发性骨肥厚（DISH）的患病率和特征。
虽然椎体骨折通常采用休息和使用胸衣进行保守治疗，但对于 DISH 患者的椎体骨折，建议采用刚性内固定手术。因此，根据是否存在 DISH，椎体骨折的治疗策略有所不同。然而，只有少数研究调查了椎体骨折患者中 DISH 的患病率。
共纳入 159 例（49 名男性和 110 名女性，平均年龄 82.9 岁）新诊断为新鲜椎体骨折并需要入住 HITO 医院的患者。新鲜椎体骨折的诊断采用 X 线成像、计算机断层扫描和磁共振成像进行，并评估 DISH 的存在情况。此外，比较了 DISH 组和非 DISH 组患者的年龄、性别、骨密度（年轻成人平均值的%）、血液检查结果、治疗和住院时间。
椎体骨折患者中 DISH 的比例为 33.9%（159 例患者中有 54 例）。男性和女性的比例分别为 38.8%和 31.8%，性别之间无显著差异（P=0.39）。DISH 组患者比非 DISH 组患者年龄更大（83.6 岁比 79.4 岁，P=0.009），DISH 组患者糖化血红蛋白 A1c 更高（P=0.005）、骨密度更高（P=0.042），住院时间更长（P=0.0001）。
椎体骨折患者中 DISH 的比例为 33.9%。鉴于 DISH 患者可能需要不同的治疗方法，需要仔细观察。
3 级。
