Lee Su-Hun, Son Dong Wuk, Lee Jun-Seok, Sung Soon-Ki, Lee Sang Weon, Song Geun Sung
Department of Neurosurgery, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea.
Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea.
Neurospine. 2020 Jun;17(2):443-452. doi: 10.14245/ns.2040076.038. Epub 2020 Jun 30.
The ''disc degeneration precedes facet joint osteoarthritis'' hypothesis and multidimensional analysis were actively discussed in lumbar spine. However, in cervical spine degeneration, the multifactorial analyzes of disc degeneration (DD), Modic changes (Mcs), facet degeneration, and endplate degeneration (ED) is still limited. In this cross-sectional study, we aimed to analyze the prevalence and interrelationship of cervical DD parameters.
We retrospectively recruited 62 patients aged between 60 and 70 years. The disc height, segmental angle, ossified posterior longitudinal ligament (OPLL), ED, facet joint degeneration (FD), uncovertebral joint degeneration (UD), DD, spinal stenosis (SS), Mc, and cord signal change (CS) were evaluated using a previously well-known grading system.
The prevalence of cervical degenerative parameters were DD (grade 1, 1.2%; grade 2, 13.3%; grade 3, 54.8%; grade 4, 19.0%; grade 5, 11.7%), OPLL (26.2%), SS (grade 0, 7.7%; grade 1, 42.3%; grade 2, 26.2%; grade 3, 23.8%), UD (39.1%), ED (normal, 69.0%; focal defect, 9.7%; corner defect, 11.7%; erosion, 6.9%; sclerosis, 2.8%), and FD (normal, 48.8%; narrowing, 27.0%; hypertrophied, 24.2%). The interrelationship of degenerative parameters showed close relation between UD, SS, DD, OPLL, Mc. ED, and CS has partial relation with degenerative finding. FD only has relation with UD, and Mc.
Our results may indicate that FD is a degeneration that occurs independently, rather than as a result of other degenerative factors.
“椎间盘退变先于小关节骨关节炎”假说及多维度分析在腰椎研究中得到了积极讨论。然而，在颈椎退变方面，对椎间盘退变（DD）、Modic改变（Mcs）、小关节退变和终板退变（ED）的多因素分析仍然有限。在这项横断面研究中，我们旨在分析颈椎DD参数的患病率及其相互关系。
我们回顾性招募了62名年龄在60至70岁之间的患者。使用先前广为人知的分级系统对椎间盘高度、节段角、后纵韧带骨化（OPLL）、ED、小关节退变（FD）、钩椎关节退变（UD）、DD、椎管狭窄（SS）、Mcs和脊髓信号改变（CS）进行评估。
颈椎退变参数的患病率分别为：DD（1级，1.2%；2级，13.3%；3级，54.8%；4级，19.0%；5级，11.7%），OPLL（26.2%），SS（0级，7.7%；1级，42.3%；2级，26.2%；3级，23.8%），UD（39.1%），ED（正常，69.0%；局灶性缺损，9.7%；角部缺损，11.7%；侵蚀，6.9%；硬化，2.8%），以及FD（正常，48.8%；狭窄，27.0%；肥大，24.2%）。退变参数之间的相互关系显示，UD、SS、DD、OPLL、Mcs之间关系密切。ED和CS与退变表现有部分关联。FD仅与UD和Mcs有关。
我们的结果可能表明，FD是一种独立发生的退变，而非其他退变因素导致。
