骨质疏松与腰椎退行性变的相关性分析

目的探讨骨质疏松与腰椎退行性变之间的内在联系,为临床预测疾病的预后、并进而采取相应的措施阻止或延缓疾病的发展进程提供客观的临床依据。方法本研究采用随机对照研究方法,随机抽取在我院住院患者180例,测试骨密度,据此分为3组:骨量正常组、骨量减少组及骨质疏松组,分别拍摄腰椎正侧位X-ray片,测量骨赘积分、椎间盘高度及椎体形变。结果 Nathan积分比较,骨质疏松组与骨量减少组及骨量正常组间有显著性差异(P0.05),骨量减少组及骨量正常组无显著性差异(P0.05);各组之间对应节段椎间盘高度差异有显著性意义(P0.05),其中,骨质疏松组的椎间盘高度明显小于骨量减少组及骨量正常组;椎体形变在低骨量组与骨量正常组之间差异不明显(P0.05),而骨质疏松组的椎体其畸形变的程度与骨量减少组及骨量正常组差异有显著性意义(P0.05),且畸形变多发生在L1、L4、L5,以ha/hp减少多见。结论骨质疏松组的腰椎退变程度最重,骨量减少组的腰椎退变程度较轻,骨量正常组的腰椎退变程度最轻,提示骨质疏松与腰椎退变呈正相关,骨质疏松可加速腰椎退变的进程。

Correlational analysis of osteoporosis and the lumbar vertebral degeneration

Objective To investigate the inner link between osteoporosis and the lumbar vertebral degeneration, in order to provide objective clinical basis for forecasting the clinical prognosis of the diseases, and to take appropriate measure to prevent or delay the development of the diseases. Methods The random controlled method was applied in this study. One hundred and eighty patients, who were hospitalized in our hospital, were randomly selected. All the patients were divided into 3 groups according to bone mineral density (BMD): the control group, the osteopenia group, and the osteoporosis group. The anteroposterior and lateral X-ray of the lumbar vertebrae were taken. Then the score of the osteophyte, the changes of the lumbar disc height, and the deformation of the vertebral body were measured. Results The Nathan scores in the osteoporosis group were significantly different to that in the osteopenia group and the control group (P<0.05), while no significant difference was observed between osteopenia group and control group (P>0.05). The difference of the height of the lumbar disc in every segment in each group was significant (P<0.05). The height of the lumbar vertebrae discs in osteoporosis group was significantly lower than that in osteopenia group and control group (P<0.05). Though the deformation of the vertebral body between osteopenia group and control group was not significant, the deformation of the vertebral body in osteoporosis group was significantly different to that in the osteopenia group and the control group (P<0.05). The deformation often occurred at L1, L4, and L5, most presenting as the decrease of ha/hp. Conclusion The degeneration of the lumbar vertebrae in osteoporosis group is the most severe, the degeneration in osteopenia group is less, and the degeneration in control group is the least. The results indicate that there is positive correlation between osteoporosis and the degeneration of the lumbar vertebrae. Osteoporosis can promote the process of the degeneration of the lumbar vertebrae.