Asymptomatic Stenosis in the Cervical and Thoracic Spines of Patients with Symptomatic Lumbar Stenosis.
Asymptomatic Stenosis in the Cervical and Thoracic Spines of Patients with Symptomatic Lumbar Stenosis.
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DOI：
10.1055/s-0035-1549031
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发表时间：
2015-10
影响因子：
2.4
通讯作者：
Riew KD
中科院分区：
文献类型：
--
作者：
Park MS;Moon SH;Kim TH;Oh JK;Lyu HD;Lee JH;Riew KD
研究设计回顾性研究。目的研究与年龄相关的退行性改变导致颈、胸、腰椎同时狭窄（三重狭窄）在文献中是罕见的。我们的目的是确定：(1)有症状性腰椎管狭窄的老年患者无症状放射性颈椎和胸椎管狭窄的发生率，(2)颈椎和胸椎同时放射性椎管狭窄的发生率，以及(3)可能预测同时胸椎管狭窄的颈椎管狭窄的放射学特征。方法回顾性分析2003年1月至2012年1月诊断为腰椎管狭窄症的80岁以上患者的全脊柱T2矢状位磁共振图像。我们纳入了无症状颈椎病和胸椎狭窄的患者。我们测量了椎体、椎管和脊髓的前后径，以及每个颈椎和胸椎节段椎间盘水平的巴甫洛夫比值和前后硬膜外狭窄。我们比较了有胸椎狭窄和无胸椎狭窄的颈椎狭窄亚组的影像学参数。结果460例腰椎管狭窄患者中，110例（23.9%）合并放射性颈椎管狭窄，112例（24.3%）合并放射性胸椎管狭窄。56例（12.1%）患者除了症状性腰椎管狭窄外，还伴有颈椎和胸椎管狭窄（三联管狭窄）。C7-T1前路硬膜外狭窄与胸椎狭窄的高发率相关。结论老年症状性腰椎管狭窄患者无症状性胸颈管狭窄是常见的。
Study Design Retrospective study. Objective Studies on age-related degenerative changes causing concurrent stenoses in the cervical, thoracic, and lumbar spines (triple stenosis) are rare in the literature. Our objectives were to determine: (1) the incidence of asymptomatic radiologic cervical and thoracic stenosis in elderly patients with symptomatic lumbar stenosis, (2) the incidence of concurrent radiologic spinal stenosis in the cervical and thoracic spines, and (3) the radiologic features of cervical stenosis that might predict concurrent thoracic stenosis. Methods Whole-spine T2 sagittal magnetic resonance images of patients older than 80 and diagnosed with lumbar spinal stenosis between January 2003 and January 2012 were evaluated retrospectively. We included patients with asymptomatic spondylotic cervical and thoracic stenosis. We measured the anteroposterior diameters of the vertebral body, bony spinal canal, and spinal cord, along with the Pavlov ratio and anterior or posterior epidural stenosis at the level of the disk for each cervical and thoracic level. We compared the radiologic parameters between the subgroups of cervical stenosis with and without thoracic stenosis. Results Among the 460 patients with lumbar stenosis, 110 (23.9%) had concurrent radiologic cervical stenosis and 112 (24.3%) had concurrent radiologic thoracic stenosis. Fifty-six patients (12.1%) had combined radiologic cervical and thoracic stenosis in addition to their symptomatic lumbar stenosis (triple stenosis). Anterior epidural stenosis at C7–T1 was associated with a high prevalence of thoracic stenosis. Conclusions It appears that asymptomatic radiologic cervical and thoracic stenosis is common in elderly patients with symptomatic lumbar stenosis.