Risk factors for lumbar intervertebral disc height narrowing: a population-based longitudinal study in the elderly.
Risk factors for lumbar intervertebral disc height narrowing: a population-based longitudinal study in the elderly.
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DOI：
10.1186/s12891-015-0798-5
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发表时间：
2015-11-09
影响因子：
2.3
通讯作者：
Sudo A
中科院分区：
文献类型：
--
作者：
Akeda K;Yamada T;Inoue N;Nishimura A;Sudo A
椎间盘退变的进展通常被认为与腰痛和/或退行性腰椎疾病相关，尤其是在老年人中。本研究的目的是通过影像学测量定量评估腰椎间盘高度的变化，并调查老年人椎间盘高度狭窄的危险因素。从1997年到2007年，197名至少65岁的村民参加了基线检查和每隔一年进行四次以上的随访检查，被选为本研究的对象。使用每例受试者的腰椎侧位X线片，测量L1-L2至L5-S1椎间盘高度。根据椎间盘高度的变化率将受试者分为两组：轻度降低（降低≤ 20%）和重度降低（降低> 20%）。采用逐步多元Logistic回归分析筛选与椎间盘高度狭窄显著相关的因素。每个椎间盘（IVD）水平的椎间盘高度在10年内逐渐降低（p < 0.01，所有椎间盘水平平均降低5.8%）。不同IVD节段间的椎间盘高度变化率无显著差异。女性、影像学膝关节骨关节炎和基线时腰痛与椎间盘高度狭窄风险增加相关。我们进行了第一项基于人群的老年人队列研究，使用放射学测量定量评估腰椎间盘高度。在这项研究中确定的危险因素将有助于进一步了解椎间盘退变的病理。
The progression of disc degeneration is generally believed to be associated with low back pain and/or degenerative lumbar diseases, especially in the elderly. The purpose of this study was to quantitatively evaluate changes in lumbar disc height using radiographic measurements and to investigate risk factors for development of disc height narrowing of the elderly. From 1997 to 2007, 197 village inhabitants at least 65 years-old who participated in baseline examinations and more than four follow-up examinations conducted every second year were chosen as subjects for this study. Using lateral lumbar spine radiographs of each subject, L1-L2 to L5-S1 disc heights were measured. The subjects were divided into two groups according to the rate of change in disc height: mildly decreased (≤20 % decrease) and severely decreased (>20 % decrease). A stepwise multiple logistic regression analysis was used to select those factors significantly associated with disc height narrowing. Disc height at each intervertebral disc (IVD) level decreased gradually over ten years (p < 0.01, an average 5.8 % decrease of all disc levels). There was no significant difference in the rate of change in disc height among the IVD levels. Female gender, radiographic knee osteoarthritis and low back pain at baseline were associated with increased risk for disc height narrowing. We conducted the first population-based cohort study of the elderly that quantitatively evaluated lumbar disc height using radiographic measurements. The risk factors identified in this study would contribute to a further understanding the pathology of disc degeneration.