Department of Spinal Surgery, The Third Hospital of Hebei Medical University, No.139 Ziqiang Road, Shijiazhuang, 050051, Hebei, People's Republic of China.
Hebei Medical University, Shijiazhuang, 050051, Hebei, People's Republic of China.
Eur Spine J. 2023 Jun;32(6):2059-2068. doi: 10.1007/s00586-023-07652-1. Epub 2023 Mar 20.
The goal of this study was to evaluate the possible associations between anemia and morphologic features of lumbar disc degeneration (LDD) in subjects with low back pain.
A total of 131 patients with normocytic or microcytic anemia (mean age 41.0 ± 6.4 yrs, BMI: 24.8 ± 3.3 kg/m, 12.2% men) and a matched control group of 131 patients without anemia (mean age 41.0 ± 6.4 yrs, BMI: 24.9 ± 3.1 kg/m, 12.2% men) were evaluated for LDD according to the Pfirrmann scoring system. The primary outcome was the difference of radiological features of LDD between two groups. The second outcome was the correlation between the hemoglobin (Hb) value and disc degeneration (DD). Statistical associations were assessed by Student's t-test, Chi-square test, and Spearman correlation.
Anemic patients had a significantly higher number of degenerated discs than non-anemic patients in the level of L2/3 and L3/4 (p < 0.05). We also found that the severe DD occurred more frequently in the level of L2/3, L3/4 and L5/S1 among anemic patients (p < 0.05). In addition, we noticed that the incidence of multilevel LDD happened much more frequently in patients with anemia (p < 0.05). The Hb value showed a borderline negative correlation with the total score of DD (p = 0.056).
The results suggested that patients with anemia, and those without are radiologically different with varying patterns of DD. Patients with back pain and anemia were more likely to have extensive and severe DD. Although relevant mechanisms are not yet well understood, this study improved our understandings of the pathophysiology for LDD.
本研究旨在评估腰痛患者贫血与腰椎间盘退变（LDD）形态特征之间的可能关联。
共纳入 131 例正细胞性或小细胞性贫血患者（平均年龄 41.0±6.4 岁，BMI：24.8±3.3 kg/m²，男性占 12.2%）和 131 例匹配的无贫血对照组患者（平均年龄 41.0±6.4 岁，BMI：24.9±3.1 kg/m²，男性占 12.2%），两组患者均根据 Pfirrmann 评分系统评估 LDD。主要结局是两组间 LDD 放射学特征的差异。次要结局是血红蛋白（Hb）值与椎间盘退变（DD）的相关性。通过学生 t 检验、卡方检验和 Spearman 相关性评估统计学关联。
贫血患者 L2/3 和 L3/4 水平的退变椎间盘数量明显多于非贫血患者（p<0.05）。我们还发现，在 L2/3、L3/4 和 L5/S1 水平，严重的 DD 在贫血患者中更常见（p<0.05）。此外，我们注意到贫血患者发生多节段 LDD 的发生率明显更高（p<0.05）。Hb 值与 DD 总评分呈边缘负相关（p=0.056）。
结果表明，贫血患者与非贫血患者在放射学上存在不同的椎间盘退变模式。腰痛伴贫血的患者更有可能出现广泛而严重的 DD。尽管相关机制尚不清楚，但本研究提高了我们对 LDD 病理生理学的认识。
