Fried K
Radiologe. 1978 Sep;18(9):362-8.
The overgrowth of cartilaginous and fibrous tissue of the spine in Paget's disease is described in long-term follow-up studies. On cervical manifestation the disease progressed from one vertebrae to the other with destruction of the intervertebral discs, fusion of the vertebral bodies and intervertebral joints and shortening of the affected area. On the lower thoracic and lumbar spine osteomalacia with collapse of the vertebral bodies and biconvex deformities of the discs were seen in the initial period. Several years later the discs flattened, vaulted and fused in the periphery by dystrophic bone. Fusion of the corresponding intervertebral joints and ossification fo the intervertebral ligaments developed. The involved spine was shortened. The sarcroiliacal joint spaces were obliterated in cases with involvement of adjacent bones by Paget's disease. The overgrowth advanced from the periphery towards the center. Ankylosis of sacroiliacal joints has also been observed without fusion of the intervertebral disc spaces. Relatively low age, loss of height, invalidating bone pains and osteomalacia of the pelvis were the main features in cases with spinal changes. Osteomalacia of the spine followed by ossification of intervertebral ligaments and joint capsules and later by vertebral fusion are considered to be a special form of Paget's disease.
长期随访研究描述了佩吉特病中脊柱软骨组织和纤维组织的过度生长情况。在颈椎表现方面,疾病从一个椎体发展到另一个椎体,伴有椎间盘破坏、椎体和椎间关节融合以及受累区域缩短。在胸下段和腰椎,初期可见椎体塌陷和椎间盘双凸畸形的骨软化症。几年后,椎间盘变平、隆起并在外周被营养不良性骨融合。相应的椎间关节融合和椎间韧带骨化形成。受累脊柱缩短。佩吉特病累及相邻骨骼时,骶髂关节间隙消失。过度生长从外周向中心发展。也观察到骶髂关节强直但椎间盘间隙未融合的情况。相对年轻的年龄、身高降低、使人衰弱的骨痛和骨盆骨软化是脊柱改变病例的主要特征。脊柱骨软化症随后出现椎间韧带和关节囊骨化,随后椎体融合被认为是佩吉特病的一种特殊形式。