Park Y H, Huang G S, Taylor J A, Marcelis S, Kramer J, Pathria M N, Clopton P, Resnick D
Department of Radiology, University of California, San Diego.
Radiology. 1993 Aug;188(2):561-5. doi: 10.1148/radiology.188.2.8327716.
To clarify the characteristics, extent, and frequency of spinal ossification and abnormalities of the sacroiliac joint, symphysis pubis, and hip in paralysis, routine radiographs of the lumbar spine, pelvis, and abdomen were retrospectively evaluated in 95 quadriplegic, 105 paraplegic, and 100 age-matched control patients, with attention to age and race and to spinal level and duration of paralysis. The spinal radiographs were evaluated for presence of osteophytes, syndesmophytes, paravertebral ossification, and flowing hyperostosis characteristic of diffuse idiopathic skeletal hyperostosis (DISH); the pelvic radiographs were used to measure the widths of the sacroiliac joint, hip, and symphysis pubis articulations and evaluate for presence of enthesopathy. Bone formation around vertebral bodies was often seen in quadriplegic (n = 41 [43%]) and paraplegic (n = 46 [44%]) patients. In quadriplegic patients, four distinct vertebral ossification patterns were evident: osteophytosis, paraspinal ossification resembling that found in psoriasis, syndesmophytosis, and flowing ossification similar to that in DISH. In paraplegic patients, osteophytosis was most frequent. Vertebral ossification in quadriplegic patients was significantly associated with age (P < .01) and increased in frequency and severity with increasing age.
为明确瘫痪患者脊柱骨化以及骶髂关节、耻骨联合和髋关节异常的特征、范围及频率，我们对95例四肢瘫痪患者、105例截瘫患者及100例年龄匹配的对照患者的腰椎、骨盆和腹部常规X线片进行了回顾性评估，同时关注年龄、种族、脊柱节段及瘫痪持续时间。评估脊柱X线片上是否存在骨赘、韧带骨赘、椎旁骨化以及弥漫性特发性骨肥厚（DISH）特征性的连续骨桥；骨盆X线片用于测量骶髂关节、髋关节和耻骨联合关节的宽度，并评估是否存在附着点病。在四肢瘫痪患者（n = 41 [43%]）和截瘫患者（n = 46 [44%]）中常可见椎体周围骨形成。在四肢瘫痪患者中，有四种不同的椎体骨化模式明显可见：骨赘形成、类似银屑病中所见的椎旁骨化、韧带骨赘形成以及类似于DISH的连续骨化。在截瘫患者中，骨赘形成最为常见。四肢瘫痪患者的椎体骨化与年龄显著相关（P <.01），且随着年龄增长，其频率和严重程度均增加。
