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Yaşlı Hastalarda Lomber Degeneratif Değişikliklerin Osteoporoz İle İlişkisi

Year 2016, Volume: 6 Issue: 4, 207 - 211, 29.12.2016

Abstract

Bel ağrısı etiyolojisinde osteoporoz ve omurga dejenerasyonunu rol oynamakta, ancak bu ikisinin arasındaki ilişki tamamen belirgin değildir. Bu çalışmanın amacı osteoporoz ve omurga degenerasyonun arasındaki ilişkiye açıklık getirmek ve osteoporozun omurga dejenerasyonun üzerindeki etkisini araştırmak. 
Materya method: 
Bu çalışmaya bel ağrısı olan 55 yaş üstü 82 hasta alındı. Hastalar kemik mineral indeksine göre osteoporotik ve osteopenik olarak iki gruba ayrıldı. Lomber dejeneratif değişiklik kriteri olan disk patolojisi, faset artrozu ve vertebra cisim kırığı gibi morfolojik değişiklikler,osteofitler, konkavite indeksi tüm hastalar için değerlendirildi. Dejeneratif değişikliklerin sınıflaması için gradleme sistemi kullanıldı. 
Sonuc: 
İki grup arasında vücut kitle indeksinde farklılık saptanmadı. Ancak iki grup arasında disk dejenerasyonu (p< 0.001), faset artrozu (p=0,009), diskopati derecesinde (p<0,001) anlamlı farklılık saptandı. Faset artrozu, disk dejenerasyon ve diskopati osteoporoz ile negatif korelasyon gösterdiği görüldü. Ancak vertebra cisim morfolojik değişiklikleri ile ilgili farklılık saptanmadı. 
Çıkarım: 
Mevcut çalışma osteoporozun bazı dejeneratif değişiklikler üzerinde koruyucu etki olabileceğini gösterir. Yaşlı hastalarda disk dejenerasyonunu ve faset artrozunu azaltmaktadır. Osteoporotik hastalarda osteofitler ve omurga kırıklarının disk degenerasyonu ve faset artrozu ile ilişkili olmadığı gösterildi.

References

  • Referans1 Fujiwara A, Tamai K, Yamato M, Howard S et al. The relation between facet joint osteoarthritis and disc degeneration of the lumbar spine: an MRI study. Eur Spine J, 1999, 8:396, 401
  • Referans2 Margulies JY, Payzer A, Nyska M, Neuwirth MG, Floman Y, Robin GC. The relationship between degenerative changes and osteoporosis in the lumbar spine. Clin Orthop Relat Res.1996 Mar ;(324):145-52.
  • Referans3 Nanjo Y, Morio Y, Nagashima H, Hagino H, Teshima R. Correlation between bone mineral density and intervertebral disk degeneration in pre- and postmenopausal women. J Bone Miner Metab. 2003; 21(1):22-7.
  • Referans4 Kirkaldy-Willis WH, Farfan HF. Instability of the lumbar spine. Clin Orthop Relat Res. 1982 May;(165):110-23
  • Referans5 Healy J, Vigorita VJ, Lane JM. The coexistence and characterics of osteoarthritis and osteoporosis. J Bone Joint Surg 67A:586, 1985

The Correlation Between The Degenerative Changes and Osteoporosis in The Lumbar Spine of Elderly Patients

Year 2016, Volume: 6 Issue: 4, 207 - 211, 29.12.2016

Abstract

Background: Both of Osteoporosis and spinal degeneration are in the etiology of the low back pain in elderly person but their correlation is not entirely clear. The aim of the study is to explore the relationship between osteoporosis and spinal degeneration and effects of osteoporosis on components of spinal degeneration.
Material and Method: We studied on eighty two patients older than 55 years old who had low back pain. The patients were divided in two groups which were osteoporotic and osteopenic according to the bone mineral index. Criteria of lumbar degenerative changes were evaluated for all patients, which were disc pathologies, facet arthrosis and morphological changes of vertebral body such as vertebral fracture, osteophytes and concavity index. Grading systems were used for classification of degenerative changes. 
Results: Mean BMI of subjects in two groups were not different but a significant difference between groups according to the disc degeneration (p< 0.001), facet arthrosis (p=0,009), discopathy degree (p<0,001) was found. We found that disc degeneration, discopathy and facet arthrosis were negatively correlated with osteoporosis but there was no difference in morphological changes of vertebral body. 
Conclusion: The result of the present study showed that osteoporosis could have a protective role against some kind of degenerative changes in vertebral column. It decreased the risk of disc degeneration and facet arthrosis in elderly patient. The formation of vertebral fractures and osteophytes were not always associated with disc degeneration and facet arthrosis in osteoporosis

References

  • Referans1 Fujiwara A, Tamai K, Yamato M, Howard S et al. The relation between facet joint osteoarthritis and disc degeneration of the lumbar spine: an MRI study. Eur Spine J, 1999, 8:396, 401
  • Referans2 Margulies JY, Payzer A, Nyska M, Neuwirth MG, Floman Y, Robin GC. The relationship between degenerative changes and osteoporosis in the lumbar spine. Clin Orthop Relat Res.1996 Mar ;(324):145-52.
  • Referans3 Nanjo Y, Morio Y, Nagashima H, Hagino H, Teshima R. Correlation between bone mineral density and intervertebral disk degeneration in pre- and postmenopausal women. J Bone Miner Metab. 2003; 21(1):22-7.
  • Referans4 Kirkaldy-Willis WH, Farfan HF. Instability of the lumbar spine. Clin Orthop Relat Res. 1982 May;(165):110-23
  • Referans5 Healy J, Vigorita VJ, Lane JM. The coexistence and characterics of osteoarthritis and osteoporosis. J Bone Joint Surg 67A:586, 1985
There are 5 citations in total.

Details

Journal Section Articles
Authors

Mustafa Uysal This is me

Utku Gürün This is me

Alauddin Kochai

Metin Özalay This is me

Publication Date December 29, 2016
Submission Date October 5, 2017
Published in Issue Year 2016 Volume: 6 Issue: 4

Cite

AMA Uysal M, Gürün U, Kochai A, Özalay M. Yaşlı Hastalarda Lomber Degeneratif Değişikliklerin Osteoporoz İle İlişkisi. Sakarya Tıp Dergisi. December 2016;6(4):207-211.

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