Morimoto Tadatsugu, Kobayashi Takaomi, Hirata Hirohito, Sugita Kazunari, Paholpak Permsak, Tsukamoto Masatsugu, Umeki Shun, Yoshihara Tomohito, Toda Yu
Department of Orthopedic Surgery, Faculty of Medicine, Saga University, Saga, JPN.
Department of Orthopedics, Saga University, Saga, JPN.
Cureus. 2024 Jun 12;16(6):e62235. doi: 10.7759/cureus.62235. eCollection 2024 Jun.
Background Although the correlation between reduced skin thickness and reduced bone density has been investigated, no study has evaluated skin thickness and osteoproliferative diseases, including ossification of the posterior longitudinal ligament (OPLL) and diffuse idiopathic skeletal hyperostosis (DISH). Methodology This retrospective cohort study consisted of 99 consecutive patients aged ≥60 years treated for spinal surgery at our hospital between January 2022 and March 2023. Skin thickness was measured at the dorsal side of the cervical, thoracic, and lumbar vertebrae on the sagittal cross-section image of whole-spine CT. Based on the median value, skin thickness was categorized into two groups based on a median thickness of 4 mm. Bone mineral density (BMD) was assessed. The sum of the vertebral body and intervertebral bridging osteophytes of the anterior longitudinal and posterior longitudinal ligament were defined as the OALL index and OPLL index. Serum levels of bone metabolism-related markers, such as tartrate-resistant acid phosphatase type 5b, procollagen I N-propeptide, 25-hydroxyvitamin D, and periostin, were measured. To assess the association between skin thickness and imaging findings, we calculated the adjusted odds ratios, adjusting for age, sex, and body mass index (BMI) and using univariate and multivariate logistic regression analyses. Results No significant differences were found in skin thickness in the three dorsal regions of the cervical, thoracic, and lumbar spine (median = 3.3 mm versus 3.5 mm versus 3.4 mm, p = 0.357) and bone metabolism-related markers. Adjusting for age, sex, and BMI, cervical, thoracic, and lumbar skin thicknesses were related to DISH, the OPLL index, and the OPLL and OPLL index, respectively. Conclusions Skin thickness did not correlate with BMD but with the amount of spinal ossification. A correlation was found between skin thickness and vertebral and intervertebral ossification; vertebral osteophytes, OPLL, and DISH may be more common in thicker skin.
尽管已对皮肤厚度降低与骨密度降低之间的相关性进行了研究，但尚无研究评估皮肤厚度与骨增殖性疾病，包括后纵韧带骨化（OPLL）和弥漫性特发性骨肥厚（DISH）。
这项回顾性队列研究纳入了2022年1月至2023年3月期间在我院接受脊柱手术治疗的99例年龄≥60岁的连续患者。在全脊柱CT矢状面图像上测量颈椎、胸椎和腰椎椎体背侧的皮肤厚度。根据中位数，将皮肤厚度以4mm的中位数为界分为两组。评估骨密度（BMD）。将前纵韧带和后纵韧带的椎体及椎间桥接骨赘总和定义为OALL指数和OPLL指数。测量血清骨代谢相关标志物水平，如抗酒石酸酸性磷酸酶5b、前胶原I N端前肽、25-羟基维生素D和骨膜蛋白。为评估皮肤厚度与影像学表现之间的关联，我们计算了调整后的比值比，对年龄、性别和体重指数（BMI）进行了校正，并使用单因素和多因素逻辑回归分析。
颈椎、胸椎和腰椎三个背侧区域的皮肤厚度（中位数分别为3.3mm、3.5mm和3.4mm，p = 0.357）以及骨代谢相关标志物之间未发现显著差异。校正年龄、性别和BMI后，颈椎、胸椎和腰椎皮肤厚度分别与DISH、OPLL指数以及OPLL和OPLL指数相关。
皮肤厚度与骨密度无关，但与脊柱骨化量有关。发现皮肤厚度与椎体和椎间骨化之间存在相关性；椎体骨赘、OPLL和DISH在较厚皮肤中可能更常见。
