Department of Orthopedic Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea (ROK).
Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Gyeonggi-do, Korea (ROK).
PLoS One. 2021 Sep 20;16(9):e0257735. doi: 10.1371/journal.pone.0257735. eCollection 2021.
The purpose of the present study was to reveal the relationship between degenerative changes in the cervical spine, head and neck postures, neck pain, and bone mineral density (BMD) of the total hip, femoral neck, and lumbar spine in post-menopausal females. In total, 116 females (mean age 60.4 ± 7.1 years; age range 50-80 years) were included. Participants were classified into three groups based on the T-score criteria of the total hip, femoral neck, and lumbar spine set by World Health Organization, respectively. The degree of neck pain was assessed using self-administered questionnaire, the Neck Disability Index. Cervical spine degeneration and head and neck postures were identified using the lateral cephalograms. Grading system for cervical degeneration included three categories of the radiographic alterations including disc height loss, osteophyte formation, and diffuse sclerosis. The areal BMD of the total hip, femoral neck, and lumbar spine were determined using dual-energy x-ray absorptiometry. Females with lower BMD exhibited lesser degree of neck pain and forward head posture (FHP) compared to those with normal BMD. Higher BMD seemed to be associated with more notable loss of the disc height at the level of C4-5. More prominent degenerative changes in the cervical spine were associated with higher areal BMD of the hip, femoral neck, and lumbar spine, altered head posture, and development of neck pain.
本研究旨在揭示绝经后女性颈椎退行性改变、头颈部姿势、颈部疼痛与全髋关节、股骨颈和腰椎骨密度(BMD)之间的关系。共纳入 116 名女性(平均年龄 60.4±7.1 岁;年龄范围 50-80 岁)。根据世界卫生组织(WHO)设定的全髋关节、股骨颈和腰椎 T 评分标准,将参与者分为三组。采用自我管理问卷(颈部残疾指数)评估颈部疼痛程度。使用侧位颈椎片确定颈椎退变和头颈部姿势。颈椎退变的分级系统包括椎间盘高度丧失、骨赘形成和弥漫性硬化三种影像学改变。采用双能 X 线吸收法测定全髋关节、股骨颈和腰椎的面积 BMD。与正常 BMD 相比,BMD 较低的女性颈部疼痛和前伸头位(FHP)程度较轻。较高的 BMD 似乎与 C4-5 水平椎间盘高度的明显丧失有关。颈椎更明显的退行性改变与髋关节、股骨颈和腰椎较高的面积 BMD、头位改变和颈部疼痛的发展有关。