Çelen Zekeriya Ersin, Onay Tolga
Department of Orthopaedic Surgery and Traumatology, Yalova Training and Research Hospital, Yalova, TUR.
Department of Orthopaedic Surgery and Traumatology, Göztepe Training and Research Hospital, İstanbul, TUR.
Cureus. 2023 Aug 26;15(8):e44156. doi: 10.7759/cureus.44156. eCollection 2023 Aug.
In previous studies, the relationship between BMD (bone mineral density) and LDH (lumbar disc herniation) has been investigated in young people, except for postmenopausal women. The aim of this study was to evaluate this association in postmenopausal women.
A cross-sectional analysis of 545 consecutive postmenopausal women was performed at a single center. The study included patients aged 45 to 85 with low back pain. Age, weight, height, L1-L4 BMD, L1-L4 T-score, L1-L4 Z-score, femoral neck BMD, femoral neck T-score, and femoral neck Z-score of patients were collected. MRI scans were assessed for the diagnosis of LDH. To explore the impact of the number of herniated segments, patients with LDH were further divided into single-level and multi-level LDH groups.
Five hundred and thirteen postmenopausal women were included in the final analysis. The mean age of the patients was 61.3±8.6 years in the LDH group and 58.4±7.8 years in the non-LDH group (p=0.001). The LDH group had higher lumbar (p<0.001) and femoral neck (p<0.05) BMD, T, and Z-scores than the non-LDH group. In binary logistic regression analysis, age, lumbar, and femoral neck BMD were significantly associated with LDH (p<0.001, p=0.03, and p=0.040, respectively). Patients with multi-level herniation had significantly higher rates of obesity (BMI ≥30) compared to patients with single-level herniation (58.0% vs. 47.0%; p=0.031). However, in terms of obesity rates, the LDH group and the non-LDH group were statistically similar (53.9% vs. 54.2%; p=0.961). There was no association between the single and multi-level herniation groups in terms of L1-4 and femoral neck BMD (p=0.760 and 0.435, respectively).
Higher lumbar bone mineral density and higher femoral neck bone mineral densities were found to be associated with lumber disc herniation in postmenopausal women with low back pain. These results suggest that bone mineral density assessment may be useful in clinical practice to determine which patients are at higher risk of lumbar disc herniation.
在以往的研究中，除绝经后女性外，已对年轻人中骨密度（BMD）与腰椎间盘突出症（LDH）之间的关系进行了调查。本研究的目的是评估绝经后女性中的这种关联。
在单一中心对545名连续的绝经后女性进行了横断面分析。该研究纳入了年龄在45至85岁之间且有腰痛的患者。收集了患者的年龄、体重、身高、L1-L4骨密度、L1-L4 T值、L1-L4 Z值、股骨颈骨密度、股骨颈T值和股骨颈Z值。通过MRI扫描评估以诊断腰椎间盘突出症。为了探究突出节段数量的影响，将腰椎间盘突出症患者进一步分为单节段和多节段腰椎间盘突出症组。
513名绝经后女性纳入最终分析。腰椎间盘突出症组患者的平均年龄为61.3±8.6岁，非腰椎间盘突出症组为58.4±7.8岁（p=0.001）。腰椎间盘突出症组的腰椎（p<0.001）和股骨颈（p<0.05）骨密度、T值和Z值均高于非腰椎间盘突出症组。在二元逻辑回归分析中，年龄、腰椎和股骨颈骨密度与腰椎间盘突出症显著相关（分别为p<0.001、p=0.03和p=0.040）。与单节段突出患者相比，多节段突出患者的肥胖率（BMI≥30）显著更高（58.0%对47.0%；p=0.031）。然而，就肥胖率而言，腰椎间盘突出症组和非腰椎间盘突出症组在统计学上相似（53.9%对54.2%；p=0.961）。单节段和多节段突出组在L1-4和股骨颈骨密度方面无关联（分别为p=0.760和0.435）。
在有腰痛的绝经后女性中，发现较高的腰椎骨密度和较高的股骨颈骨密度与腰椎间盘突出症相关。这些结果表明，骨密度评估在临床实践中可能有助于确定哪些患者患腰椎间盘突出症的风险更高。
