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腰椎形态学变化的放射学评估:从生命的第一个十年到第九个十年

Radiological Assessment of Morphological Changes of Lumbar Spine: From First to 9th Decade of Life.

作者信息

Moon Myung-Sang, Moon Paul S, Kim Chae-Yeon

机构信息

Moon-Kim's Clinical Institute of Orthopedic Surgery, Seoul, Korea.

Cheju Halla General Hospital, Jeju, Korea.

出版信息

Asian Spine J. 2023 Oct;17(5):870-887. doi: 10.31616/asj.2022.0199. Epub 2023 Oct 24.

Abstract

STUDY DESIGN

Analysis of lumbar spine radiograms of 1,496 Jeju islanders of Korea.

PURPOSE

To look into the age- and gender-matched incidences of morphological changes and their severities.

OVERVIEW OF LITERATURE

There have been several prior research on the prevalence and severity of age-related diseases, both related and unrelated. Those offer some fundamental clinical data for clinicians.

METHODS

Radiograms of 1,496 patients (555 males and 941 females) from the first to 9th decade were examined for this study. Sagittal and coronal alignment, disc space narrowing, spur formation including diffuse idiopathic spinal hyperostosis (DISH), spondylolisthesis, and ballooned discs associated with biconcave bodies due to osteoporosis were among the parameters of lumbar spine morphologies examined on high-quality radiographs by both human observers and computers.

RESULTS

The alignment of the lumbar spine altered after birth and set at growth maturity, and then the curve was maintained till the end of the 5th decade afterward and the curve gradually hypolordotic. There were three types of coronal alignment abnormalities can be seen: idiopathic, osteopathic, and discogenic (degenerative lumbar scoliosis [DLS]). DLS developed after 6th decade. There was no scoliosis associated with spondylolysis or the post-laminofacetectomy period. Disc space narrowing and corporal spur formation were not seen till the end of 3rd decade comparatively speaking, the corporal spurs generated in the non-scoliotic spine were smaller than those in the scoliotic spine. DISH began to appear in the 5th-decade patients and its incidences increased gradually afterward. Porosis-related vertebral body collapse started to happen after 6th decade. There are three different types of spondylolisthesis: anterior, posterior, and lateral. The lateral slip occurred only in the scoliotic spine. All types were related to degenerative discs.

CONCLUSIONS

It has been shown that the morphology of the lumbar spine changes throughout time.

摘要

研究设计

对1496名韩国济州岛居民的腰椎X光片进行分析。

目的

探究年龄和性别匹配的形态学变化发生率及其严重程度。

文献综述

此前已有多项关于年龄相关疾病患病率和严重程度的研究,涉及相关和不相关疾病。这些研究为临床医生提供了一些基础临床数据。

方法

本研究检查了1496例患者(555名男性和941名女性)从10岁到90岁的X光片。矢状面和冠状面排列、椎间盘间隙变窄、骨刺形成(包括弥漫性特发性骨肥厚症[DISH])、椎体滑脱以及因骨质疏松导致双凹形椎体相关的椎间盘膨出,均为高质量X光片上由人工观察者和计算机检查的腰椎形态学参数。

结果

腰椎排列在出生后发生改变并在生长成熟时固定,然后该曲线在50岁末之前保持,之后曲线逐渐变直。可见三种类型的冠状面排列异常:特发性、骨病性和椎间盘源性(退变性腰椎侧弯[DLS])。DLS在60岁后出现。未发现与椎弓根峡部裂或椎板关节突切除术后相关的脊柱侧弯。相对而言,直到30岁末才出现椎间盘间隙变窄和椎体骨刺形成,非脊柱侧弯脊柱中产生的椎体骨刺比脊柱侧弯脊柱中的小。DISH在50岁患者中开始出现,此后其发生率逐渐增加。与骨质疏松相关的椎体塌陷在60岁后开始发生。有三种不同类型的椎体滑脱:前滑脱、后滑脱和侧方滑脱。侧方滑脱仅发生在脊柱侧弯的脊柱中。所有类型均与退变椎间盘有关。

结论

研究表明腰椎形态随时间变化。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b223/10622814/fb0526b99daf/asj-2022-0199f1.jpg

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引用本文的文献

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