休曼病与症状性胸段脊髓狭窄症的关系：一项回顾性研究。
Relationship between Scheuermann disease and symptomatic thoracic spinal stenosis: A retrospective study.
作者信息
Ding Yan, Lv Shiqiao, Dong Shengjie, Cui Jinpeng, Cao Zhilin, Chen Yunzhen
机构信息
Department of Spine, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China;Department of Orthopaedics, Yantaishan Hospital, Yantai, China.
Department of Orthopaedics, Yantaishan Hospital, Yantai, China.
出版信息
Acta Orthop Traumatol Turc. 2021 May;55(3):253-257. doi: 10.5152/j.aott.2021.20022.
OBJECTIVE
This study aimed to investigate the possible relationship between Scheuermann disease (SD) and the pathophysiological factors of thoracic spinal stenosis (TSS), including ossification of the ligamentum flavum (OLF), ossification of the posterior longitudinal ligament (OPLL), and thoracic disc herniation (TDH) in patients with symptomatic TSS.
METHODS
Demographic and radiological data from 66 consecutive patients diagnosed with symptomatic TSS from 2013 to 2018 were retrospectively collected and divided into 3 groups depending on the underlying pathomechanism of TSS: TDH group (18 patients; 6 women; mean age ± standard deviation [Sd] = 59.89 ± 11.34), OPLL group (12 patients; 8 women; mean age ± Sd = 56.08 ± 14.74), and OLF group (36 patients; 20 women; mean age ± Sd = 58.69 ± 9.77). A total of 41 age-matched healthy individuals (19 women; mean age ± Sd = 54.88 ± 13.63) were designated as the control group. In each group, both typical and atypical SD criteria were radiologically examined. The demographic data and presence of SD between the control group and 3 subgroups of TSS pathomechanisms were evaluated.
RESULTS
SD characteristics were identified in 83.33% (15/18) of patients in the TDH group, 44.44% (16/36) in the OLF group, 25% (3/12) in the OPLL group, and 17.07% (7/41) of the control individuals. When analyzed by the chi-squared test and logistic regression analysis, the presence of SD was significantly associated with TDH (P < 0.01) and OLF (P < 0.05) but not OPLL (P > 0.05). Patients with TDH and OLF showed peak involvement of T10/11, and patients with OPLL did not. Furthermore, we determined that age, sex, body-mass index, and smoking status were not the risk factors for TDH, OPLL, and OLF (P > 0.05). SD was found to be a risk factor for TDH (P < 0.01) and OLF (P < 0.05) but not for OPLL (P > 0.05).
CONCLUSION
Evidence from this study indicated that SD might be a risk factor for OLF and TDH but not for OPLL.
目的
本研究旨在探讨休门氏病（SD）与症状性胸段脊髓狭窄（TSS）的病理生理因素之间的可能关系，这些因素包括黄韧带骨化（OLF）、后纵韧带骨化（OPLL）以及症状性TSS患者的胸椎间盘突出（TDH）。
方法
回顾性收集了2013年至2018年连续诊断为症状性TSS的66例患者的人口统计学和放射学数据，并根据TSS的潜在发病机制将其分为3组：TDH组（18例患者；6例女性；平均年龄±标准差[Sd]=59.89±11.34）、OPLL组（12例患者；8例女性；平均年龄±Sd=56.08±14.74）和OLF组（36例患者；20例女性；平均年龄±Sd=58.69±9.77）。总共41例年龄匹配的健康个体（19例女性；平均年龄±Sd=54.88±13.63）被指定为对照组。在每组中，均对典型和非典型SD标准进行了放射学检查。评估了对照组与TSS发病机制的3个亚组之间的人口统计学数据和SD的存在情况。
结果
TDH组83.33%（15/18）的患者、OLF组44.44%（16/36）的患者、OPLL组25%（3/12）的患者以及17.07%（7/41）的对照个体中发现了SD特征。经卡方检验和逻辑回归分析，SD的存在与TDH（P<0.01）和OLF（P<0.05）显著相关，但与OPLL无关（P>0.05）。TDH和OLF患者的T10/11受累最为明显，而OPLL患者则不然。此外，我们确定年龄、性别、体重指数和吸烟状况不是TDH、OPLL和OLF的危险因素（P>0.05）。发现SD是TDH（P<0.01）和OLF（P<0.05）的危险因素，但不是OPLL的危险因素（P>0.05）。
结论
本研究的证据表明，SD可能是OLF和TDH的危险因素，但不是OPLL的危险因素。
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