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目的:分析成人退行性腰椎侧凸与骨质疏松的相关性。方法:2004年1月至2009年6月门诊及病房共收治退行性腰椎侧凸患者69例,男6例,女63例;年龄51～82岁,平均69.3岁;所有患者均行X线、MRI检查,确诊并记录患者侧凸Cobb角;对照组50例,男9例,女41例,均为非腰椎侧凸患者,其中腰椎管狭窄症37例,腰间盘突出症8例,腰椎滑脱症4例,腰椎管内占位1例,平均年龄62.6岁。应用双能X线吸收法测定腰椎(L2～L4)及股骨颈、股骨粗隆和Ward′s三角骨密度值及T值,分析患者年龄、Cobb角与对应T值的相关性。结果:在69例退行性腰椎侧凸患者中,平均T值为-2.8±1.9,分布在-0.9～-4.7之间,合并骨质疏松52例,骨量减少14例;对照组平均T值-1.2±1.6,分布在0.4～-2.8之间;两组比较差异有显著性(P<0.05)。骨质疏松程度与年龄呈明显正相关,而与Cobb角无相关。结论:骨质疏松症是退行性腰椎侧凸发病的危险因素,同时骨质疏松程度随着年龄的增大而增加,但与侧凸程度无明显相关。
Objective: To analyze the correlation between adult degenerative lumbar scoliosis and osteoporosis. Methods: From January 2004 to June 2009, 69 patients with degenerative lumbar scoliosis were treated in clinic and ward, including 6 males and 63 females, aged from 51 to 82 years, with an average of 69.3 years. All patients underwent X-ray, MRI examination, diagnosed and recorded in patients with Cobb angle; control group of 50 patients, 9 males and 41 females, were non-lumbar scoliosis patients, including 37 cases of lumbar spinal stenosis, lumbar disc herniation in 8 cases, lumbar 4 cases of spondylosis, lumbar spinal canal occupying a case, the average age of 62.6 years old. Dual energy X-ray absorptiometry was used to measure the BMD and T values of lumbar spine (L2 ~ L4) and femoral neck, femur trochanter and Ward’s triangle. The correlation between age and Cobb angle and corresponding T value was analyzed. Results: Among 69 patients with degenerative lumbar scoliosis, the mean T value was -2.8 ± 1.9, ranging from -0.9 to -4.7. There were 52 cases with osteoporosis and 14 cases with osteopenia. The average T value -1.2 ± 1.6, distributed between 0.4 ~ -2.8; There was significant difference between the two groups (P <0.05). The degree of osteoporosis was positively correlated with age, but not with Cobb angle. Conclusion: Osteoporosis is a risk factor for degenerative lumbar scoliosis. At the same time, the degree of osteoporosis increases with age, but it has no significant correlation with the degree of scoliosis.