绝经后女性骨密度与腰椎间盘退变程度的相关性研究

目的探讨绝经后女性骨密度与腰椎间盘退变程度的相关性。方法回顾性研究西南医科大学附属医院2017年1月至2019年12月收治的因慢性腰痛住院的251例绝经后女性患者。收集患者的年龄、绝经年限、体质量指数(body mass index,BMI)。采用双能X线骨密度仪检测患者腰椎(L_(1～4))及髋部平均骨密度,根据骨密度T值将患者分为骨量正常组(n=45)、骨量低下组(n=71)和骨质疏松组(n=135)。同时患者均行腰椎MRI检查,采用Pfirrmann分级系统评估腰椎间盘退变程度(L1/2、L2/3、L3/4、L4/5、L5/S1)。采用Spearman相关性分析骨密度与腰椎间盘退变程度的关系。结果骨质疏松组和骨量低下组的年龄、绝经年限显著大于骨量正常组(P0.05)。骨质疏松组和骨量低下组的BMI明显小于骨量正常组(P0.05)。骨质疏松组和骨量低下组的L1/2、L2/3、L3/4、L1～S1(L1/2～L5/S1的平均值)椎间盘退变评分明显高于骨量正常组(P0.05)。骨质疏松组的L4/5、L5/S1椎间盘退变评分高于骨量正常组(P0.05),骨量低下组与骨量正常组比较差异无统计学意义(P0.05)。相关性分析结果显示,骨密度与BMI呈正相关(P0.05),与年龄、绝经年限、L1/2、L2/3、L3/4、L4/5、L5/S1、L1～S1椎间盘退变评分呈负相关(P0.05)。结论绝经后女性骨密度与BMI呈正相关,与年龄、绝经年限、腰椎间盘退变程度呈负相关。绝经后女性骨密度越低,其腰椎退变程度越严重。     

骨质疏松与腰椎间盘退变相关性的研究进展

骨质疏松和腰椎间盘退变是骨科临床常见的退行性疾病,两者存在相似的发病机制,骨密度值反映了骨质疏松的严重程度,其与椎间盘退变程度的相关性一直是研究热点。一种观点认为骨密度值与腰椎间盘退变的严重程度呈正相关,有观点则认为是负相关,也有学者认为没有关联。本文将对近年来骨密度与腰椎间盘退变的相关性作一综述,并探讨两者之间相关联的发病机制。     

腰椎间盘退变和骨密度的相关性分析

目的通过对临床病例腰椎间盘退变分级、MRI-T1ρ值与相应骨密度(bone mineral density,BMD)的相关性分析,推断腰椎间盘退行性变与原发性骨质疏松的相关性关系。方法 2014年4月-2015年4月我院骨科病例共338例,并对其进行腰椎影像学检查和骨密度检查,测得所有病例的腰椎间盘退变的Pfirrmann分级、椎间盘MRI-T1ρ值及相应骨密度(T值),并行前两者与骨密度的统计学相关性分析,进而分析探讨腰椎间盘退变与相应骨密度的相关性。结果 Pfirrmann腰椎间盘退变MRI分级与相应骨密度存在显著相关关系(r=-0.206,P0.01)。腰椎间盘MRI-T1ρ值与相应骨密度存在显著相关关系(r=0.312,P0.01)。结论腰椎间盘退变与原发性骨质疏松存在显著的相关关系。     

腰椎不稳定与腰椎间盘退变程度的相关性分析

目的：探讨腰椎不稳定与腰椎间盘退变程度的相关性。方法：随机选择100例腰腿痛病人,根据第一病人的腰椎功能位X线片和腰椎MRI图片,确定椎间盘的退变程度及有无节段不稳,并分析二者间关系。结果：L3－S1共有36个节段不稳,占12％;腰椎不稳29例,占病人总数的29％,L4／5、L3／4、L5／S1的不稳定发生率分别为22％、10％和4％;腰椎不稳与病人年龄分组呈现密切正相关,腰椎不稳与单节段退变及总退变度密切正相关,结论：腰椎不稳与椎间盘退变和蔼密切相关,但并非严重退变一定会发生节段不稳。     

绝经后女性骨密度与腰椎间盘退变的相关性分析

目的:观察绝经后女性腰椎和髋部骨密度与腰椎间盘退变的关系。方法:回顾性统计2017年12月～2018年12月因腰痛在我院脊柱外科门诊及住院的229例绝经后女性患者,记录患者年龄、身高、体重、糖尿病史、高血压病史、饮酒史、吸烟史等,采用双能X线骨密度测量仪检查患者腰椎椎体(L1～L4)骨密度和髋部平均骨密度,记录相应的T值,每例患者同时行腰椎MRI检查。根据骨密度T值≥-1.0为正常,-2.5 2 vs 24.72±2.96kg/...     

腰椎退变与腰椎间盘突出症的预防

腰椎间盘突出症是一种常见多发病 ,目前治疗方法虽多 ,少数患者疗效仍欠佳 ,因此注意预防更为重要 ,我科对3 5 6例腰椎间盘突出症病人从腰椎退变的角度分析和探讨腰椎间盘突出症的病因提出以预防为主 ,治疗为辅的观点和方法 :1　临床资料1.1　一般资料　本组男 2 2 0例 ,女 13 6例 ,男女比例约为 1.64 :1,年龄 15～ 80岁 ,平均 41.2岁 ,其中 2 1～ 60岁 3 2 4例 ,占 91% (表 1)。表 1　 365例腰椎间盘突出症年龄分组年龄组别 (岁 )例数百分比例 (% )1 5～ 2 0 7 22 1～ 30 55 1 5.531～ 40 1 0 7 304 1～ 50 1 1 7 32 .951～ 60 4 5 1 2 .66…     

吸烟与腰椎间盘退变的相关性

目的:探讨吸烟与腰椎间盘退变程度的相关性。方法:随机选择2014年1月~2014年12月因腰痛在我院脊柱外科门诊就诊的200例成年男性患者,详细问诊患者年龄、身高、体重、糖尿病史、高血压史、饮酒史、吸烟史、职业等一般情况,根据吸烟史将患者分为吸烟组与非吸烟组,每例患者行腰椎MRI检查,用Pfirrmann分级系统对各节段腰椎间盘进行分级,用VAS量表对患者腰痛程度评分,用SPSS 19.0分析吸烟与腰椎间盘退变及腰痛程度的相关性。结果:两组患者一般资料无显著性差异(P0.05)。吸烟组Pfirrmann分级为4、5级的椎间盘比例高于非吸烟组(P0.05)。在L1/2水平分级为2级、4级、5级,在L2/3水平分级为2级、4级,在L3/4水平分级为2级、3级、4级、5级,在L4/5水平分级为3级、4级,在L5/S1水平分级为3级、5级的椎间盘比例,两组间有显著性差异(P0.05)。在吸烟组中,Pfirrmann分级为4、5级的椎间盘比例在L1/2、L2/3水平高于L4/5、L5/S1水平,且有显著性差异(P0.05)。吸烟组腰痛VAS评分(5.00±1.30)高于非吸烟组(4.06±2.41),且有显著性差异(P0.05)。结论:吸烟加剧腰椎间盘退变,且吸烟会加重患者腰痛程度。另外,吸烟对上腰椎间盘的影响大于下腰椎间盘。     

腰椎间盘退变/突出的分期及其病理学

腰腿痛是危害人类健康的常见病，据估计约80％以上的人一生中发生一次以上的严重腰腿痛，为此投入的医疗保健费用也颇为可观，如英国每年花费约120亿英镑用于诊治腰腿痛。尽管大多数下腰痛原因不完全清楚，但椎间盘退变及其继发性改变被认为最重要原因之一，各种针对椎间盘病变的治疗方法多可获得良好效果。近10年来，随着     

腰椎间盘突出症与腰椎骨密度的相关性研究

目的 研究腰椎间盘突出症(lambar disc herniation,LDH)与骨质疏松(osteoporosis,OP)的相关性,探讨腰椎间盘突出症对骨密度的影响.方法 选取腰椎间盘突出症组患者82例,对照组健康体检人群41例,利用定量CT(quantitative computed tomography,QCT)测定其骨密度(bone mineral density,BMD),分析比较两组的骨密度值.并对腰椎间盘突出症组患者病程:≤1年与＞1年,腹肌肌力≤3级与≥4级骨密度值变化进行比较分析.结果 腰椎间盘突出症组患者的骨密度值较对照组低,骨量减少者在腰椎间盘突出症组中的构成比较对照组高,但差异均无统计学意义(P>0.05).其病程、腹肌肌力对腰椎间盘突出症组患者骨密度值变化的影响无统计学差异(P>0.05).结论 腰椎间盘突出症对骨密度有一定的影响,但两者的关系不显著,腰椎间盘突出症并非骨质疏松的独立影响因素.     

骨质密度改变与腰椎间盘退变的关系，一项基于18F-FDG标记的PET-CT研究

目的通过对临床病例腰椎间盘退变分级与相应骨质密度(bone mineral density,BMD)和平均标准摄取值(standard uptake value,SUV)的分析,推断腰椎间盘退行性变(intervertebral disc degeneration,IDD)与BMD和SUV的关系。方法以集群抽样的取样方法,从2011年1月至2015年10月于我院行PET-CT检查的5013例病人中,纳入了224例符合标准的病人,年龄在30~87岁之间,其中男性148例,女性76例。两组性别间年龄无统计学差异。采用西门子PET-CT扫描仪行全身18FFDG显像,扫描范围:头顶到大腿中部。测量腰3、4、5椎体CT平扫骨质密度,分析在不同性别间L3-4,L4-5椎间盘相关BMD值和SUV值的差异,及其与腰椎间盘退变的关系。结果 L3-4,L4-5椎间盘相关BMD值和SUV值在不同性别间差异没有统计学意义,但是在老年组(年龄在65~87)有显著性差异。老年女性BMD值和SUV值均低于老年男性。IDD组的骨密度值低于非IDD组(P0.05),IDD组的SUV值高于非IDD组(P0.05)。各个级别IDD的L3-4和L4-5BMD值不全相同,整体趋势是随着IDD分级越高,BMD值越低。结论 IDD引起骨质密度值降低,和相应椎体代谢的增高。     

The relationship between disc degeneration and flexibility of the lumbar spine.

BACKGROUND CONTEXT: A relationship between degenerative changes of the intervertebral disc and biomechanical functions of the lumbar spine has been suggested. However, the exact relationship between the grade of disc degeneration and the flexibility of the motion segment is not known. PURPOSE: To investigate the relationship between degenerative grades of the intervertebral disc and three-dimensional (3-D) biomechanical characteristics of the motion segment under multidirectional loading conditions. STUDY DESIGN/SETTING: A biomechanical and imaging study of human cadaveric spinal motion segments. METHODS: One hundred fourteen lumbar motion segments from T12-L1 to L5-S1 taken from 47 fresh cadaver spines (average age at death, 68 years; range, 39 to 87 years) were used in this study. The severity of degeneration (grades I to V according to Thomson's system) was determined using magnetic resonance (MR) images and cryomicrotome sections. Pure unconstrained moments with dead weights were applied to the motion segments in six load steps. The directions of loading included flexion, extension, right and left axial rotation, and right and left lateral bending. RESULTS: When the MR images were graded, 2 segments had grade I disc degeneration; 45, grade II; 20, grade III; 26, grade IV; and 21, grade V. When the cryomicrotome sections were graded, 14 segments had grade I disc degeneration; 31, grade II; 22, grade III; 26, grade IV; and 21, grade V. Segments from the upper lumbar levels (T12-L1 to L3-4) tended to have greater rotational movement in flexion, extension, and axial rotation with disc degeneration up to grade IV, whereas the motion decreased when the disc degenerated to grade V. In the lower lumbar spine at L4-5 and L5-S1, motion in axial rotation and lateral bending was increased in grade III. CONCLUSIONS: These results suggest that kinematic properties of the lumbar spine are related to disc degeneration. Greater motion generally was found with disc degeneration, particularly in grades III and IV, in which radial tears of the annulus fibrosus are found. Disc space collapse and osteophyte formation as found in grade V resulted in stabilization of the motion segments.     

The relationship between disc degeneration, facet joint osteoarthritis, and stability of the degenerative lumbar spine

Degenerative processes in the disc and facet joints affect the stability of the motion segment. The exact relations among disc degeneration, facet joint osteoarthritis, and the kinematics of the motion segment are not well defined in the literature. Magnetic resonance imaging and functional radiography of the lumbar spine were analyzed to examine the relations among segmental instability, facet joint osteoarthritis, and disc degeneration in patients with degenerative disorders of the lumbar spine. Seventy consecutive patients (mean age, 46 years) had both magnetic resonance imaging and flexion and extension radiographs of the lumbar spine. The lumbar instability was classified into abnormal tilting on flexion, rotatory instability in the sagittal plane, and translatory instability. Translatory instability was subdivided into anterior, posterior, and anteroposterior translatory instability. Disc degeneration as seen on T2-weighted sagittal images was classified into five grades. Facet joint osteoarthritis as seen on axial T1-weighted images was divided into four grades. This study revealed that the kinematics of the lumbar motion segment are affected by disc degeneration and facet joint osteoarthritis. Abnormal tilting movement on flexion and anteroposterior translatory instability both had negative associations with facet joint osteoarthritis. However, anterior translatory instability was positively associated with disc degeneration and facet joint osteoarthritis. Rotatory instability in the sagittal plane and posterior translatory instability were not associated with disc degeneration and facet joint osteoarthritis.     

绝经后妇女肥胖与骨密度的关系

目的 分析绝经后妇女的腰椎2-4( L2-4)和股骨颈（Neck)、大转子(Troch)、粗隆间（InterTro)的骨密度（BMD),探讨绝经后妇女肥胖与骨密度的关系。方法 以我院269名年龄45 -75岁的绝经后妇女为研究对象,计算体重指数将研究对象分为肥胖组和对照组,采用双能X线骨密度仪检测腰椎、股骨颈、大转子、粗隆间的骨密度,分析绝经后妇女肥胖与骨密度的关 系。结果 肥胖组绝经后妇女不同部位的骨密度均高于对照组(P <0.05或P <0. 01)。绝经后妇女各部位的骨密度随年龄的增长而降低,各年龄组间的骨密度有显著性差异(P <0.05或P <0. 01)。结论 年龄和体重指数是影响骨密度的重要因素,绝经后妇女肥胖者骨密度较正常体型者高,肥胖者可能通过负重等作用,延缓绝经后妇女骨密度的下降。