中老年患者骨质疏松与颈椎退变的相关性研究

Correlation between osteoporosis and cervical spine degeneration in middle-aged and elderly patients

目的探讨中老年患者骨质疏松与颈椎退变程度的相关性。方法分析2019年1月至2022年5月在郑州大学第一附属医院骨科行颈椎CT检查的107例45岁以上患者,其中男60例,女47例,年龄(55.65±5.26)岁。测量颈椎C2~C7各椎体松质骨上中下3个横断面的CT值,根据颈椎CT值,将患者分为骨质疏松组与骨量正常组。采用Pathria的CT分级标准评估颈椎小关节退变以反映颈椎退变程度。采用Spearman相关分析检验颈椎骨质疏松与颈椎退变程度的相关性。结果107例患者C2~C7椎体CT值为(307.91±64.66)HU,骨质疏松组患者C2~C7椎体CT值为(269.70±51.70)HU,骨量正常组患者CT值为(342.70±55.10)HU。骨质疏松组和骨量正常组患者的性别、年龄、身高、体重、体重指数(BMI)等一般资料组间差异无统计学意义(P>0.05),C2/3、C3/4、C4/5、C5/6、C6/7、C7/T1退变平均评分均与C2~C7椎体CT均值呈负相关,其中C2/3退变程度与C2~C7椎体CT均值相关性最为显著(r=-0.611,P<0.01)。结论中老年患者骨质疏松越重,C2~C7椎体CT均值越低,颈椎小关节退变评分越高,颈椎退变越重,中老年患者骨质疏松与颈椎退变呈正相关。

Objective To analyze the correlation between osteoporosis and the degree of cervical spine degeneration in middle-aged and elderly patients.Methods From January 2019 to May 2022,107 patients over 45 years old who underwent cervical spine CT examination in the Department of Orthopedics,the First Affiliated Hospital of Zhengzhou University,including 60 males and 47 females,were(55.65±5.26)years old.The CT values of the upper,middle and lower sections of the cancellous bone of each vertebral body of the cervical spine C2-C7 were measured.According to the CT values of the cervical spine,the patients were divided into the osteoporosis group and the normal bone mass group.The cervical facet joint degeneration was evaluated by Pathria′s CT grading standard to reflect the degree of cervical degeneration.Spearman correlation analysis was used to test the correlation between cervical osteoporosis and cervical degeneration.Results The CT value of C2-C7 vertebral body of 107 patients was(307.91±64.66)HU,the CT value of C2-C7 vertebral body of osteoporosis group was(269.70±51.70)HU,and the CT value of normal bone mass group was(342.70±55.10)HU.There was no significant difference in the gender,age,height,weight,body mass index(BMI)and other general data between the osteoporosis group and the normal bone mass group(P>0.05),the average score of degeneration in C2/3,C3/4,C4/5,C5/6 was negatively correlated with the mean value of CT in C2-C7 vertebrae,and the degree of C2/3 degeneration was most significantly correlated with the mean value of C2-C7 vertebral body CT(r=-0.611,P<0.01).Conclusion The more severe the osteoporosis in middle-aged and elderly patients,the lower the mean value of C2-C7 vertebrae,the higher the cervical facet joint degeneration score,and the more severe cervical spine degeneration.There is a positive correlation between osteoporosis and cervical spine degeneration in middle-aged and elderly patients.