脊柱退行性疾病的骨质疏松影响分析

Analysis of the effect of osteoporosis on the spinal degenerative diseases

目的研究低转换型骨质疏松与脊柱退行性疾病之间的相互关系,并探讨骨质疏松对老年人脊柱退变的危害。方法使用双能X线骨密度测量仪检测,临床观察及影像学资料,大样本随机抽样,spss13.0统计学软件对数据进行分析,研究一年来505例50岁以上的患者,分析统计低转换型骨质疏松症的脊柱病变。结果各年龄组不同腰椎椎体骨密度之间比较采用单因素方差分析,计数资料采用Spearman等级相关分析,骨质疏松与腰椎失稳等疾病之间的相关分析采用非条件logistic回归分析。发现胸腰椎骨折的偏回归系数为1.026,Wald检验结果 P=0.021<0.05,有统计学意义,OR值为2.789;脊柱退行性变的偏回归系数为0.225,Wald检验结果P=0.035<0.05,有统计学意义,OR值为2.253;腰椎失稳的偏回归系数为0.828,Wald检验结果 P=0.004<0.05,有统计学意义,OR值为2.289;腰椎滑脱的偏回归系数为0.782,Wald检验结果 P=0.024<0.05,有统计学意义,OR值为2.185;颈椎病的偏回归系数为0.691,Wald检验结果P=0.045<0.05,有统计学意义,OR值为1.211;椎管狭窄的偏回归系数为0.972,Wald检验结果 P=0.031<0.05,有统计学意义,OR值为2.570;脊柱畸形的偏回归系数为0.972,Wald检验结果 P=0.025<0.05,有统计学意义,OR值为1.002;年龄的偏回归系数为0.048,Wald检验结果 P=0.000<0.05,有统计学意义,OR值为1.049;性别的偏回归系数为-1.035,Wald检验结果 P=0.000<0.05,有统计学意义,OR值为0.355。骨质疏松,脊柱退行性病(脊柱退行性变、脊柱不稳、胸腰椎骨折、椎管狭窄、脊柱畸形、颈椎病、脊柱滑脱)与年龄增加相关。结论年龄增加,低转换型骨质疏松增加;骨量丢失,骨质疏松能加速脊柱退变。骨质疏松加速脊柱退行性变、脊柱不稳、胸腰椎骨折、椎管狭窄、脊柱畸形、颈椎病、脊柱滑脱等脊柱退行性疾病的发病。

Objective To investigate the relationship between low remodelling osteoporosis and the spinal degenerative diseases, and to explore the damage of osteoporosis on the spine degeneration in the elderly patients. Methods The bone mineral density （BMD） was detected using dual-energy X-ray absorptiometry. The clinical observation and the collection of the imaging data were performed. The large-sample random sampling was also performed. A SPSS 13.0 statistical software was used to analyze all the data of 505 patients over 50 years old in a year. The data of the spinal diseases with low remodelling osteoporosis were collected. Results The comparison of BMD of different lumbar vertebrae in each group was performed using single factor analysis of variance. The enumeration data were analyzed using Spearman rank correlation analysis. The correlation between osteoporosis and diseases such as the lumbar instability was analyzed using non-conditional logistic regression analysis. The results revealed that the partial regression coefficient of the thoraco-lumbar fracture was 1. 026 （P = 0. 021, OR 2. 789）. The partial regression coefficient of the spinal degeneration was 0. 225 （P = 0. 035, OR 2. 253 ）. The partial regression coefficient of the lumbar instability was 0. 828 （ P = 0. 004, OR 2. 289）. The partial regression coefficient of the spondylolisthesis was 0. 782 （ P = 0. 024, OR 2. 185 ）. The partial regression coefficient of the cervical spondylosis was 0. 691 （ P = 0. 045, OR 1. 211 ）. The partial regression coefficient of the spinal stenosis was 0. 972 （ P = 0. 031, OR 2.57）. The partial regression coefficient of the spinal deformity was 0. 972 （ P = 0. 025, OR 1. 002）. The partial regression coefficient of age was 0. 048 （P = 0. 000, OR 1. 049）. The partial regression coefficient of gender was - 1. 035 （P = 0. 000, OR 0. 355）. Osteoporosis and the spinal degenerative diseases, including the spinal degeneration, the spinal instability, the thoraco-lumbar fractures, the spinal stenosis, the spinal deformity, the cervical spondylosis, and the spondylolisthesis, were correlated with the increase of age. Conclusion Along with the increase of age, the incindence of low remodeling osteoporosis increases. Bone loss and osteoporosis can both accelerate the spinal degeneration. Osteoporosis can also accelerate the spinal degenerative diseases, such as the spinal degeneration, the spinal instability, the thoraco-lumbar fractures, the spinal stenosis, the spinal deformity, the cervical spondylosis, and the spondylolisthesis.