Haramati L B, Alterman D D, Israel G M, Mallavurapu R, Haramati N
Department of Radiology, Albert Einstein College of Medicine, Jacobi Medical Center, Bronx, NY 10467, USA.
Skeletal Radiol. 1998 Oct;27(10):565-8. doi: 10.1007/s002560050438.
To assess the prevalence of complications related to osteopenia in the thoracic spine (anterior wedging and fish vertebrae) of patients admitted for substance abuse detoxification.
We retrospectively identified 150 sequential patients admitted to our drug and alcohol detoxification ward in whom posteroanterior and lateral admission chest radiographs and clinical charts were available for review. There were 116 men and 34 women with a mean age of 37 years (range 19-67 years). Thirty-eight patients were admitted for drug detoxification, 37 for alcohol detoxification, and 75 for drug and alcohol detoxification. These patients were compared with 66 age- and sex-matched controls from our hospital's employee health service. Two radiologists reviewed all chest radiographs for the presence of anterior wedging and fish vertebrae in the thoracic spine and other nonspinal fractures. Serum calcium and inorganic phosphorus levels were recorded for the substance abuse detoxification patients.
Forty-nine percent (n=73) of detoxification patients had complications of osteopenia in the thoracic spine including: anterior wedging (n=47), fish vertebrae (n=21), or both (n=5). Twenty-four percent (n=36) of patients had an elevated serum inorganic phosphorus level and one patient had an elevated serum calcium level. Patients with anterior wedging or fish vertebrae included: 45% (n=45) of patients below age 40 years, 35% (n=12) of women, 41% (n= 15) of drug detoxification patients, 58% (n=22) of alcohol detoxification patients, 48% (n=36) of drug and alcohol detoxification patients, and 47% (n=17) of patients with elevated serum inorganic phosphorus (P=NS). Six percent (n=9) of our study population had nonspinal fractures on their chest radiographs. Twenty-one percent (n=14) of controls had complications of osteopenia in the thoracic spine (all anterior wedging). This prevalence differed significantly (P<0.05, chi-squared) from the study population.
Osteopenia-related anterior wedging and fish vertebrae in the thoracic spine are common findings on chest radiographs of patients hospitalized for substance abuse detoxification. Serum inorganic phosphorus and calcium levels did not correlate with the presence of anterior wedging or fish vertebrae.
评估因药物滥用戒毒入院患者胸椎骨质减少相关并发症（椎体前缘楔形变和鱼椎样变）的患病率。
我们回顾性确定了150例连续入住我院药物和酒精戒毒病房的患者，这些患者均有入院时的后前位和侧位胸部X光片以及临床病历可供审查。其中男性116例，女性34例，平均年龄37岁（范围19 - 67岁）。38例患者因药物戒毒入院，37例因酒精戒毒入院，75例因药物和酒精戒毒入院。将这些患者与我院员工健康服务中心66例年龄和性别匹配的对照者进行比较。两名放射科医生审查了所有胸部X光片，以确定胸椎椎体前缘楔形变、鱼椎样变以及其他非脊柱骨折情况。记录了药物滥用戒毒患者的血清钙和无机磷水平。
49%（n = 73）的戒毒患者存在胸椎骨质减少相关并发症，包括：椎体前缘楔形变（n = 47）、鱼椎样变（n = 21）或两者皆有（n = 5）。24%（n = 36）的患者血清无机磷水平升高，1例患者血清钙水平升高。存在椎体前缘楔形变或鱼椎样变的患者包括：40岁以下患者中的45%（n = 45）、女性中的35%（n = 12）、药物戒毒患者中的41%（n = 15）、酒精戒毒患者中的58%（n = 22）、药物和酒精戒毒患者中的48%（n = 36）以及血清无机磷升高患者中的47%（n = 17）（P值无统计学意义）。研究人群中有6%（n = 9）的患者胸部X光片显示有非脊柱骨折。21%（n = 14）的对照者存在胸椎骨质减少相关并发症（均为椎体前缘楔形变）。该患病率与研究人群有显著差异（P < 0.05，卡方检验）。
在因药物滥用戒毒住院患者的胸部X光片中，胸椎骨质减少相关的椎体前缘楔形变和鱼椎样变是常见表现。血清无机磷和钙水平与椎体前缘楔形变或鱼椎样变的存在无关。
