Schönnagel Lukas, Camino-Willhuber Gaston, Braun Sebastian, Zhu Jiaqi, Tani Soji, Guven Ali E, Caffard Thomas, Chiapparelli Erika, Arzani Artine, Haffer Henryk, Muellner Maximilian, Shue Jennifer, Duculan Roland, Bendersky Mariana, Cammisa Frank P, Girardi Federico P, Sama Andrew A, Mancuso Carol A, Hughes Alexander P
Department of Orthopaedic Surgery, Hospital for Special Surgery, Weill Cornell Medicine, New York City, NY.
Center for Musculoskeletal Surgery, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Spine (Phila Pa 1976). 2024 Apr 1;49(7):478-485. doi: 10.1097/BRS.0000000000004847. Epub 2023 Oct 5.
A retrospective analysis of prospectively collected data.
To assess the association between intervertebral disk degeneration and hip and knee osteoarthritis (OA) in patients with degenerative lumbar spondylolisthesis.
The co-occurrence of hip OA and degenerative spinal pathologies was first described as the "hip-spine syndrome" and has also been observed in knee OA. It remains unclear whether both pathologies share an underlying connection beyond demographic factors.
Intervertebral disk degeneration was classified by the Pfirrmann Classification and intervertebral vacuum phenomenon. Intervertebral vacuum phenomenon was classified into mild (1 point), moderate (2 points), and severe (3 points) at each level and combined into a lumbar vacuum score (0-15 points). Similarly, a lumbar Pfirrmann grade was calculated (5-25 points). Patients with previous hip or knee replacement surgery were classified as having an OA burden. We used multivariable regression to assess the association between OA and disk degeneration, adjusted for age, body mass index, and sex.
A total of 246 patients (58.9% female) were included in the final analysis. Of these, 22.3% had OA burden. The multivariable linear regression showed an independent association between OA burden and lumbar vacuum (β = 2.1, P <0.001) and Pfirrmann grade (β = 2.6, P <0.001). Representing a 2.1 points higher lumbar vacuum and 2.6 points higher lumbar Pfirrmann grade after accounting for demographic differences.
Our study showed that OA burden was independently associated with the severity of the intervertebral disk degeneration of the lumbar spine. These findings give further weight to a shared pathology of OA of large joints and degenerative processes of the lumbar spine.
对前瞻性收集的数据进行回顾性分析。
评估退变性腰椎滑脱患者椎间盘退变与髋、膝骨关节炎（OA）之间的关联。
髋骨关节炎与退变性脊柱疾病的共存最早被描述为“髋-脊柱综合征”，在膝骨关节炎中也有观察到。目前尚不清楚这两种疾病在人口统计学因素之外是否存在潜在联系。
根据Pfirrmann分级和椎间盘真空现象对椎间盘退变进行分类。椎间盘真空现象在每个节段分为轻度（1分）、中度（2分）和重度（3分），并合并为腰椎真空评分（0-15分）。同样，计算腰椎Pfirrmann分级（5-25分）。既往有髋或膝关节置换手术的患者被归类为有OA负担。我们使用多变量回归评估OA与椎间盘退变之间的关联，并对年龄、体重指数和性别进行了调整。
最终分析纳入了246例患者（58.9%为女性）。其中，22.3%有OA负担。多变量线性回归显示，OA负担与腰椎真空评分（β = 2.1，P <0.001）和Pfirrmann分级（β = 2.6，P <0.001）之间存在独立关联。在考虑人口统计学差异后，腰椎真空评分高2.1分，腰椎Pfirrmann分级高2.6分。
我们的研究表明，OA负担与腰椎间盘退变的严重程度独立相关。这些发现进一步支持了大关节OA与腰椎退变过程存在共同病理机制的观点。
3级。
