摘要
目的 探讨骨密度 (BMD)改变与腰段脊柱退变之间关系 .方法 受试对象依据 WHO有关骨质疏松诊断标准分为正常对照组 (1 0例 )、骨量减少组 (2 1例 )及骨质疏松组 (2 8例 ) ,比较 3组间 BMD值、脊柱退变 Nathan积分 ,椎间盘高度和小关节对称度 ,探讨 BMD对脊柱退变的影响 ,并对低 BMD下椎体畸形变进行了初步分析 .结果 1 Nathan积分同BMD值呈负相关 (r=- 0 .435 ,P<0 .0 1 ) . 2与对照组相比 ,骨质疏松组在 L3,L4,L5 平面小关不同对称的发生率分别为5 3.5 % ,82 .1 % ,6 0 .7% ,显著增高 (P<0 .0 1 ) ,在 L1 /2 ,L5 /S1椎间盘高度分别为 (6 .79± 3.6 6 ) m m,(7.1 4± 3.6 5 ) mm ,明显降低 (P<0 .0 5 ,P<0 .0 1 ) ,而低骨量组仅在 L5 平面小关节不对称发生率增高 (71 .4% ,P<0 .0 1 ) ,在 L4/5 ,L5 /S1 椎间盘高度明显降低 [(6 .5 8± 1 .7) mm ,(7.83± 2 .98) mm,P<0 .0 1 ]. 3椎体形变以前楔形为主 ,且多发生在 L1 ,L4,L5 .结论 骨质疏松形成的微型骨折使椎体变形 ,椎间盘退变及后关节肥大 ,内聚 ,应力不稳 ,三者共同导致脊柱的力学特性失常 ,加速脊柱退变 .
AIM To analyze the relationship between bone mineral density (BMD) and lumbar spinal degeneration. METHODS Fifty nine subjects aging from 40 to 85 years old were divided into three groups (normal, osteoporosis and osteopenia). They were respectively studied for the existence of lumbar spinal degeneration and low BMD by observing the value of BMD, the score of Nathan's, the height of disc, the facet joint tropism, the facet angle and the deformity of vertebrae. RESULTS ① An inverse correlation was observed between BMD and the score of Nathan's ( r =-0.045, P <0.01). ② In osteoporosis group, the occurrence rate of lumbar facet asymmetry at L 3, L 4 and L 5 was 53.5%, 82.1% and 60.7% respectively, higher than those in control ( P < 0.01 ). The height of disc at L 1/2 and L 5/S 1 was (6.79± 3.66 ) mm and (7.14±3.65) mm respectively, lower than those in control ( P <0.05, P <0.01). In the group of osteopenia, only at L 5, lumbar facet asymmetry was seen. At L 4/5 and L 5/S 1 the height of disc was lower than those in control ( P <0.01). ③ The deformity of vertebrae was mainly wedge shaped vertebrae, mostly at L 1, L 4 and L 5. CONCLUSION Microfractures of osteoporosis cause the vertebral deformity, the degeneration of disc, facet joint tropism and lumbar facet asymmetry, which together result in the spinal instability and accelerate the degeneration of spine.
出处
《第四军医大学学报》
2000年第1期52-55,共4页
Journal of the Fourth Military Medical University
关键词
骨密度
骨质疏松
脊柱退行性变
bone mineral density
osteoporosis
degeneration
