Gamada Hisanori, Funayama Toru, Nakagawa Takane, Sunami Takahiro, Sakashita Kotaro, Inomata Kento, Okuwaki Shun, Asada Tomoyuki, Shibao Yosuke, Miura Kousei, Noguchi Hiroshi, Takahashi Hiroshi, Shiina Itsuo, Nakagawa Tsukasa, Yamazaki Masashi, Koda Masao
Department of Orthopaedic Surgery, Institute of Medicine, University of Tsukuba, Tsukuba, Japan.
Department of Orthopaedic Surgery, Ibaraki Western Medical Center, Chikusei, Japan.
Spine Surg Relat Res. 2024 May 10;8(6):616-622. doi: 10.22603/ssrr.2024-0032. eCollection 2024 Nov 27.
Disc degeneration is a risk factor of pyogenic spondylitis. However, its degree in patients with pyogenic spondylitis is unknown. This study aimed to determine differences in disc degeneration between patients with pyogenic spondylitis and those with noninfectious lumbar spondylosis.
A total of 85 patients with lumbar pyogenic spondylitis (the infected group) and 156 with lumbar spondylosis who underwent posterior lumbar interbody fusion (the noninfected group) were retrospectively evaluated. Patients with a previous history of spinal fusion, tuberculous spondylitis, and multilevel infection and those receiving dialysis were excluded. Magnetic resonance imaging of the lumbar spine was conducted. Each disc at the L1/2-L5/S levels was graded. The total score of the four discs, excluding the affected disc, was used as the modified disc degenerative disease (DDD) score. Propensity score matching was performed using independent variables such as age, sex, diabetes mellitus, cancer, and steroid use. The modified DDD scores at all and each disc level were compared between the two matched groups.
After matching, 48 patients in the infected group and 88 in the noninfected group were finally included in the study. The mean modified DDD scores of the infected and noninfected groups were 7.63 and 5.40, respectively. The modified DDD scores at all and each disc level were higher in the infected group than in the noninfected group.
The incidence of disc degeneration at all and each disc level was higher in patients with pyogenic spondylitis than in those with noninfectious lumbar spondylosis.
椎间盘退变是化脓性脊柱炎的一个危险因素。然而，化脓性脊柱炎患者的椎间盘退变程度尚不清楚。本研究旨在确定化脓性脊柱炎患者与非感染性腰椎病患者之间椎间盘退变的差异。
回顾性评估了85例接受后路腰椎椎间融合术的腰椎化脓性脊柱炎患者（感染组）和156例腰椎病患者（非感染组）。排除既往有脊柱融合病史、结核性脊柱炎、多节段感染病史以及接受透析的患者。对腰椎进行磁共振成像检查。对L1/2-L5/S节段的每个椎间盘进行分级。将除患侧椎间盘外的四个椎间盘的总分作为改良椎间盘退变疾病（DDD）评分。使用年龄、性别、糖尿病、癌症和类固醇使用等自变量进行倾向得分匹配。比较两组匹配后改良DDD评分在所有椎间盘水平和每个椎间盘水平的差异。
匹配后，感染组48例患者和非感染组88例患者最终纳入研究。感染组和非感染组的平均改良DDD评分分别为7.63和5.40。感染组在所有椎间盘水平和每个椎间盘水平的改良DDD评分均高于非感染组。
化脓性脊柱炎患者在所有椎间盘水平和每个椎间盘水平的椎间盘退变发生率均高于非感染性腰椎病患者。
