Marcelli C, Yates A J, Barjon M C, Pansard E, Angelloz-Pessey L, Simon L
Division of Rheumatology, Lapeyronie Hospital, Montpellier, France.
Spine (Phila Pa 1976). 1995 Feb 15;20(4):454-9. doi: 10.1097/00007632-199502001-00008.
A retrospective radiologic analysis of Paget's disease of the spine.
The prevalence, anatomic distribution, mechanisms of formation of Pagetic vertebral ankylosis (PVA) and the possibility of a relationship to diffuse idiopathic skeletal hyperostosis (DISH) were assessed in a large population of persons with Paget's disease.
Acquired vertebral ankylosis is not a common feature of the Paget's disease of the spine and its mechanisms of formation remain unknown. In some reports, PVA was associated with radiographic signs of DISH.
Of 337 Pagetic patients monitored in the Division of Rheumatology from 1961 to 1990, all 245 who had entire spine radiographs were selected for study. Radiographs were studied for signs of Pagetic vertebral lesions and for spinal lesions of DISH.
The study group contained 156 men with a mean age of 68 years (range 37-92) and 89 women with a mean age of 71 years (range 50-89). Fourteen PVA were observed on the radiographs of 11 men (mean age 68 years; range 60-76). One PVA was cervical, eight were thoracic, one thoracolumbar, three lumbar, and one lumbosacral. Eighty of the two hundred forty-five patients (32.6%) had characteristic features of DISH. Eight out of the eleven patients with PVA also had evidence of spinal lesions of DISH and radiographic features of DISH were observed contiguous to ten of the fourteen PVA.
The scarcity of PVA reported in the literature and in our study (4.4% of 245 patients) suggests that constant progression of the disease from one vertebra to another by invasion of intervertebral disc space is rare. However, the higher incidence of PVA in men, their preferential location at the thoracic spine and their association with lesions of DISH suggest that progression of Pagetic lesions by invasion of bridging osteophytes may be an important mechanism for the intervertebral spread of Paget's disease.
对脊柱佩吉特病进行回顾性放射学分析。
在大量佩吉特病患者中评估佩吉特性椎体融合（PVA）的患病率、解剖分布、形成机制以及与弥漫性特发性骨肥厚（DISH）相关的可能性。
获得性椎体融合并非脊柱佩吉特病的常见特征，其形成机制尚不清楚。在一些报告中，PVA与DISH的放射学表现相关。
在1961年至1990年风湿病科监测的337例佩吉特病患者中，选取有全脊柱X光片的245例进行研究。对X光片进行研究，以寻找佩吉特性椎体病变的迹象和DISH的脊柱病变迹象。
研究组包括156名男性，平均年龄68岁（范围37 - 92岁）和89名女性，平均年龄71岁（范围50 - 89岁）。在11名男性（平均年龄68岁；范围60 - 76岁）的X光片中观察到14例PVA。1例PVA位于颈椎，8例位于胸椎，1例位于胸腰段，3例位于腰椎，1例位于腰骶段。245例患者中有80例（32.6%）具有DISH的特征性表现。11例PVA患者中有8例也有DISH脊柱病变的证据，并且在14例PVA中的10例附近观察到DISH的放射学特征。
文献及我们的研究中报道的PVA较少（245例患者中的4.4%），提示疾病通过椎间盘间隙侵袭从一个椎体持续进展到另一个椎体的情况很少见。然而，男性中PVA的发病率较高、其在胸椎的偏好位置以及与DISH病变的关联表明，通过桥接骨赘侵袭导致佩吉特病变进展可能是佩吉特病椎间扩散的重要机制。
