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PubMed2001

The role of cumulative physical work load in lumbar spine disease: risk factors for lumbar osteochondrosis and spondylosis associated with chronic complaints.

OBJECTIVES: To investigate the relation with a case-control study between symptomatic osteochondrosis or spondylosis of the lumbar spine and cumulative occupational exposure to lifting or carrying and to working postures with extreme forward bending. METHODS: From two practices and four clinics were recruited 229 male patients with radiographically confirmed osteochondrosis or spondylosis of the lumbar spine associated with chronic complaints. Of these 135 had additionally had acute lumbar disc herniation. A total of 197 control subjects was recruited: 107 subjects with anamnestic exclusion of lumbar spine disease were drawn as a random population control group and 90 patients admitted to hospital for urolithiasis who had no osteochondrosis or spondylosis of the lumbar spine radiographically were recruited as a hospital based control group. Data were gathered in a structured personal interview and analysed using logistic regression to control for age, region, nationality, and other diseases affecting the lumbar spine. To calculate cumulative forces to the lumbar spine over the entire working life, the Mainz-Dortmund dose model (MDD), which is based on an overproportional weighting of the lumbar disc compression force relative to the respective duration of the lifting process was applied with modifications: any objects weighing >or=5 kg were included in the calculation and no minimum daily exposure limits were established. Calculation of forces to the lumbar spine was based on self reported estimates of occupational lifting, trunk flexion, and duration. RESULTS: For a lumbar spine dose >9 x 10(6) Nh (Newton x hours), the risk of having radiographically confirmed osteochondrosis or spondylosis of the lumbar spine as measured by the odds ratio (OR) was 8.5 (95% confidence interval (95% CI) 4.1 to 17.5) compared with subjects with a load of 0 Nh. To avoid differential bias, forces to the lumbar spine were also calculated on the basis of an internal job exposure matrix based on the control subjects' exposure assessments for their respective job groups. Although ORs were lower with this approach, they remained significant. CONCLUSIONS: The calculation of the sum of forces to the lumbar spine is a useful tool for risk assessment for symptomatic osteochondrosis or spondylosis of the lumbar spine. The results suggest that cumulative occupational exposure to lifting or carrying and extreme forward bending increases the risk for developing symptomatic osteochondrosis or spondylosis of the lumbar spine.

Adult↗

PubMed1981

Spondylosis deformans and diffuse idiopathic skeletal hyperostosis (DISH) in Finland.

A population study with 6-year follow-up of 6 167 persons aged over 30 was carried out in nine population groups in Southern Finland. Estimation of spondylosis and DISH (Diffuse Skeletal Hyperostosis) was made from lateral chest X-rays. Reliability coefficients (kappa) in the repeat reading of 1 025 films ranged between 0.60 and 0.76. 214 cases of newly developed DISH and 1 080 of spondylosis were observed. With the exception of 4 new cases, all cases of DISH had developed in persons who had had spondylosis at baseline or developed it during the follow-up. The sexual incidence of spondylosis was fairly similar, i.e. 4 cases per 100 person years in both. Prevalence and incidence of spondylosis were highest in rural areas, in persons with strenuous occupations and in the obese. Incidence of DISH was 0.7 cases per 100 person years in men and 0.4 in women. DISH was equally common in all types of population. It was not associated with arduousness of occupation. Obesity and-to a lesser degree-diabetes mellitus and glucose intolerance were associated with DISH. Neither condition was associated with elevated serum calcium, serum cholesterol or bacteriuria. The study supports the concept that DISH is epidemiologically and pathogenetically different from spondylosis deformans.

Adult↗

PubMed1998

Familial cervical spondylosis. Case report.

Cervical spondylosis is a disease that is often attributed to aging and considered the result of degenerative changes in the spine. The idea that there is a genetic predisposition to develop diseases of the skeletal elements of the spine has been discussed previously, but has never been proven conclusively. The authors report three cases of severe cervical spondylosis in patients who are first-degree relatives: a mother and her two sons. All three individuals had cervical disc herniations and stenosis at C3-4, C4-5, C5-6, and C6-7, and all three required decompressive procedures. The location and degree of cervical spondylosis were as similar among these three patients as they have been in identical twins reported in other studies. Such familial inheritance of cervical spondylosis has been reported only once. The existence of familial cervical spondylosis is not an unrealistic proposal because other studies have shown that genetics determines the shape of one's spine and that similar spines tend to degenerate in similar ways. Therefore, genetic counseling for a family such as the one reported here may prove to be of great benefit to warn siblings that they are at high risk for cervical spine injury. However rare it might be, familial cervical spondylosis may be a phenomenon that any spine surgeon should suspect in a family with cervical spine abnormalities found in several members.

Adult↗

PubMed1990

Thoracic spondylosis: experience of 4 cases.

Thoracic spondylosis is relatively uncommon compared to cervical or lumbar spondylosis. It may cause spinal canal stenosis and result in radiculopathy, neurogenic claudication, and most commonly, myelopathy. We present our experience in the management of 4 cases with symptomatic thoracic spondylosis. The lower thoracic spine was involved in all 4 cases. The pathological changes are almost the same as in cervical or lumbar spondylosis except that ossification of ligamenta flava is more common in thoracic spondylosis. The ossified ligamenta flava may adhere tightly to the dura mater, and therefore increase the difficulty of operation. The results of decompressive laminectomy for thoracic spondylosis were acceptable.

Adult↗

PubMed2006

Effects of alfacalcidol alone or in combination with elcatonin on incidence of osteoporotic vertebral fractures in postmenopausal women with spondylosis.

Osteoporosis and spondylosis often occur simultaneously. However, there are no previous reports about the effects of osteoporosis medication on incidence of vertebral fractures in people with spondylosis. In this study, we conducted a retrospective investigation of the effects of alfacalcidol alone or in combination with elcatonin on incidence of osteoporotic vertebral fractures in women with spondylosis. The present subjects were 101 postmenopausal women with osteoporosis aged >60 years, divided into three groups: D group (n = 45), treated for >5 years with alfacalcidol; D+ECT group (n = 26), treated for >5 years with alfacalcidol plus elcatonin; control group (n = 30), who received no medications for >5 years. Over the 5-year treatment period, bone mineral density (BMD) of the lumbar spine and proximal femur did not significantly change in the D and D+ECT groups, but they significantly decreased in the control group (P < 0.05). The number of incident vertebral fractures per patient was significantly higher in the control group (2.9) than in the D group (1.2) and D+ECT group (1.5) (P < 0.01). There was no significant difference in BMD or incident vertebral fractures between the D and D+ECT groups. In all three groups, the number of incident vertebral fractures positively correlated with the number of prevalent vertebral fractures (0.303 </= r </= 0.434), and negatively correlated with baseline BMD (-0.703 </= r </= -0.326) and the osteophyte score representing the degree of spondylosis (-0.769 </= r </= -0.365). Further multiple regression analysis revealed that the medication (D or D+ECT, P < 0.001) and the osteophyte score (P < 0.001) were the most significant contributors for the number of incident vertebral fractures. In conclusion, elcatonin had no additive effects on BMD or prevention of vertebral fractures in postmenopausal women receiving alfacalcidol. Presence of spondylosis (indicated by a high osteophyte score) appears to have an effect on prevention of vertebral fractures.

Aged↗

PubMed1992

The association of cervical spondylosis and multiple sclerosis.

The diagnostic and therapeutic considerations produced by the coexistence of cervical spondylosis and multiple sclerosis are complex. We have encountered six patients, affected by both multiple sclerosis and cervical spondylosis, in whom neurosurgical procedures were performed. The diagnosis of multiple sclerosis was confirmed by a combination of clinical, neuroimmunologic, electrophysiologic, and neuroradiologic findings. The diagnosis of spondylosis with spinal cord compromise was confirmed by myelography and computed tomographic scan in all cases, and by magnetic resonance imaging in four. Surgery was followed by lasting clinical improvement in two patients, transient improvement in one, and no change in the other three. Our experience confirms that multiple sclerosis and cervical spondylosis can coexist and suggests that this coexistence may result in an interaction that compounds the deleterious effect on the nervous system. Diagnostic evaluations of patients, particularly young patients, with symptoms of cervical spondylosis should include consideration of the possible coexistence of multiple sclerosis. The evaluation of a patient with known multiple sclerosis who develops new signs of cervical spinal cord dysfunction should always include spinal neuroimaging studies. When progression of symptoms coincides with documented progression of anatomic compression, surgical intervention can yield good results.

Adult↗

PubMed2002

Association of klotho gene polymorphism with bone density and spondylosis of the lumbar spine in postmenopausal women.

Based on the fact that the klotho-deficient mouse exhibits multiple aging phenotypes, including osteopenia and subchondral sclerosis of joints, we explored the possibility of whether human klotho gene polymorphism is associated with two major age-related skeletal disorders: osteoporosis and spondylosis. Analysis of the CA repeat sequence downstream of the final exon of the klotho gene identified ten types of alleles in Japanese postmenopausal women (n = 377). We investigated the association of this microsatellite polymorphism with bone density and spondylosis score of the lumbar spine. None of the genotypes was associated with bone density in the overall population (n = 377; 754 alleles) nor in the subpopulation at not more than 10 years after menopause ( 20 years after menopause (n = 102; 204 alleles, p = 0.024). The type 7 allele was associated with high bone density in women more than 20 years after menopause (p = 0.042). The association study with spondylosis of postmenopausal women (n = 221) revealed that another distinct allele, type 8, was significantly associated with low spondylosis score at L-4/5 (p = 0.019) and L-5/S-1 (p = 0.048) levels in the subpopulation equal to or younger than the average age (<or=63 years old, n = 119; 238 alleles), but not in the older subpopulation. These findings indicate that the klotho gene may be a candidate for the genetic regulation of common age-related diseases like osteoporosis and spondylosis, and we provide the first evidence suggesting that this gene may be involved in the etiology of human diseases.

Adult↗

PubMed1995

Development of degenerative spondylosis of the lumbar spine after partial discectomy. Comparison of laminotomy, discectomy, and posterolateral discectomy.

STUDY DESIGN: The development of degenerative spondylosis after successful operative decompression of the affected nerve root was prospectively evaluated in a comparative case series of 100 patients with a herniated lumbar nucleus pulposus. OBJECTIVES: The objective of this study was to compare the relative incidence of degenerative spondyloarthrosis after successful posterior laminotomy and discectomy and posterolateral extradural discectomy for decompression of a compromised lumbar nerve root. SUMMARY OF BACKGROUND DATA: The relationship between the radiographic appearance of degenerative spondylosis and prior operative procedures has been controversial and at times contradictory. The posterior operative approach with a partial discectomy has been associated with a significant incidence of postoperative degenerative spondylosis and intraneural and perineural fibrosis, complications that may be minimized, or perhaps even eliminated, with the posterolateral evacuation of the offending intervertebral disc fragment. METHODS: Each patient had: 1) not responded favorably to nonoperative treatment, 2) a persistent radiculopathy, 3) correlative imaging studies with no preoperative spondyloarthrosis and 4) minimum 2-year follow-up. Fifty patients were treated by posterior laminotomy and discectomy and fifty were treated by a posterolateral extradural discectomy. Postoperative spondylosis was graded based on the radiographic presence or absence of osteophytes, the intervertebral disc height, the vertebral body alignment and the facet joint changes. RESULTS: At an average postoperative follow-up of 65 months, the incidence of a one grade increase in degenerative spondylosis was 80% of the laminotomy and discectomy patients as compared to 39% of the posterolateral discectomy patients. CONCLUSIONS: The increased incidence of spondyloarthrosis with the posterior approach suggests that minimally invasive posterolateral extradural procedures should be considered for the decompression of a compromised lumbar nerve root.

Diskectomy↗

PubMed2003

Inverse relation between osteoporosis and spondylosis in postmenopausal women as evaluated by bone mineral density and semiquantitative scoring of spinal degeneration.

STUDY DESIGN: The relation between bone mineral density and severity of spondylosis was evaluated in postmenopausal women. OBJECTIVE: To examine the possible inverse relation between osteoporosis and spondylosis by evaluating the association between bone mineral density and osteophyte formation or intervertebral disc narrowing using a semiquantitative scoring system. SUMMARY OF BACKGROUND DATA: The literature contains studies demonstrating an inverse relation between osteoporosis and spondylosis as well as those documenting insufficient support for such a relation. However, in these studies, only limited-range grading systems (e.g., Grades 1-4) were used to evaluate the severity of spondylosis. METHODS: In this study, 104 postmenopausal women older than 60 years underwent bone mineral density measurement of the lumbar spine (anteroposterior, lateral, and midlateral) and proximal femur (femoral neck, trochanter, and Ward's triangle) using dual-energy x-ray absorptiometry. Raw data representing the semiquantitative osteophyte score and disc score as well as the number of vertebral fractures were obtained using spinal radiograph. Correlations between bone mineral density and the radiographic variable were then analyzed. RESULTS: Significant negative correlations were found between all bone mineral density data and the number of vertebral fractures (-0.524 < or r= r < or = -0.347; P < 0.05). Marginal/moderate positive correlations were observed between the osteophyte score and the bone mineral density data (0.263 < or = r < or = 0.580, P < 0.05), and between the disc score and the bone mineral density data (0.233 < or = r < or = 0.570, P < 0.05).CONCLUSIONS On the basis of the finding that spondylotic changes in postmenopausal women exhibit positive correlations not only with the lumbar bone mineral density, but also with the remote-site bone mineral density, this study supports the view that osteoporosis has an inverse relation with spondylosis.

Aged↗

PubMed2003

[Influence of cervical curvature change on the nerve root and vertebral artery of patients with cervical spondylosis and clinical observation of manipulation treatment].

OBJECTIVE: To observe the influence of the change of cervical curvature on the nerve root and the vertebral artery of the patients with cervical spondylosis and the curative effect of therapeutic manipulations. METHODS: Sixty cases of cervical spondylosis with the change of cervical curvature, 60 cases of cervical spondylosis without the change of cervical curvature and 60 normal people were chosen. They were clinically observed and the cervical spondylosis was treated by manipulations and the data was processed according to the principle of statistics. RESULTS: The change of cervical curvature affected the nerve root and the vertebral artery and therapeutic manipulations produced a satisfactory curative effect. CONCLUSION: Cervical spondylosis with change of cervical curvature has special characteristics in the etiology, course and state of the disease. The change of cervical curvature produces an effect on the nerve root and the vertebral artery. Selected therapeutic manipulations produce a better curative effect.

Adult↗

PubMedDate not supplied

Neurophysiological investigation of cervical spondylosis.

The difficulties in diagnosing spinal cord lesions due to the cervical spondylosis is well-known in clinical neurology. In order to investigate the contribution of various neurophysiological examinations in the diagnosis in cervical spondylosis, we examined 70 patients suffering from cervical spondylosis, with peripheral nerve conduction studies, F-wave from the upper limb and electromyography from the corresponding muscles, as well as somatosensory evoked potentials (SEPs) from upper and lower limbs. Patients were separated into four groups: 20 patients had cervical spondylosis symptoms only; 15 patients had symptoms and signs of spinal root involvement; 15 patients had symptoms and signs of myelopathy; and 20 patients had symptoms and signs of both myelopathy and spinal root involvement. A group of 20 normal controls was also studied. In all groups of patients SEPs were the most sensitive electrophysiological study. Low-amplitude N13 and increased conduction time of N9-N13 and central conduction N13-N19 and LP-P27 were the most common finding in SSEP testing. SEPs were affected in many cases without CT-MRI findings of spinal cord pressure. From the above findings, SEPs proved to be the most sensitive diagnostic investigation in cervical spondylosis.

Adult↗

PubMed1976

[The antero-posterior diameter of the cervical spinal canal in cervical spondylosis (author's transl)].

1. The antero-posterior diameter (APD) of the cervical spinal canals in 96 healthy adults, 108 cases of radiological cervical spondylosis (asymptomatic) and 96 cases of cervical spondylosis with radiculopathy or radiculomyelopathy was measured for each vertebra by the method of Burrows. (Filmfocus distance was 1.2m). 2. The APD in patients with symptomatic spondylosis was found to be significantly narrower than those of without. 3. Since the upper limit of APD at C4 to C6 vertebrae in symptomatic spondylosis was 16 mm, while the lower limit of APD in asymtomatic spondylosis was 14 mm, the following conclusion appears justified. 1) When the APD is narrower than 16 mm, the osteophytes along the posterior border of the spinal bodies or degenerative disc protrusions may produce cervical radiculomyelopathy, although the cord and the roots may escape from compression by the spondylotic changes even when the APD is wider than 14 mm. 2) When the APD is narrower than 13 mm, it is almost always certain that the osteophytes or herniated discs compress the cervical cord and roots.

Adult↗

PubMed2005

Surgery for degenerative lumbar spondylosis.

BACKGROUND: Surgical investigations and interventions account for large health care utilisation and costs, but the scientific evidence for most procedures is still limited. OBJECTIVES: Degenerative conditions affecting the lumbar spine are variously described as lumbar spondylosis or degenerative disc disease (which we regarded as one entity) and may be associated with back pain and associated leg symptoms, instability, spinal stenosis and/or degenerative spondylolisthesis. The objective of this review was to assess current scientific evidence on the effectiveness of surgical interventions for degenerative lumbar spondylosis. SEARCH STRATEGY: We searched CENTRAL, MEDLINE, PubMed, Spine and ISSLS abstracts, with citation tracking from the retrieved articles. We also corresponded with experts. All data found up to 31 March 2004 are included. SELECTION CRITERIA: Randomised (RCTs) or quasi-randomised trials of surgical treatment of lumbar spondylosis. DATA COLLECTION AND ANALYSIS: Two authors assessed trial quality and extracted data from published papers. Additional information was sought from the authors if necessary. MAIN RESULTS: Thirty-one published RCTs of all forms of surgical treatment for degenerative lumbar spondylosis were identified. The trials varied in quality: only the more recent trials used appropriate methods of randomization, blinding and independent assessment of outcome. Most of the earlier published results were of technical surgical outcomes with some crude ratings of clinical outcome. More of the recent trials also reported patient-centered outcomes of pain or disability, but there is still very little information on occupational outcomes. There was a particular lack of long term outcomes beyond two to three years. Seven heterogeneous trials on spondylolisthesis, spinal stenosis and nerve compression permitted limited conclusions. Two new trials on the effectiveness of fusion showed conflicting results. One showed that fusion gave better clinical outcomes than conventional physiotherapy, while the other showed that fusion was no better than a modern exercise and rehabilitation programme. Eight trials showed that instrumented fusion produced a higher fusion rate (though that needs to be qualified by the difficulty of assessing fusion in the presence of metal-work), but did not improve clinical outcomes, while there is other evidence that it may be associated with higher complication rates. Three trials with conflicting results did not permit any conclusions about the relative effectiveness of anterior, posterior or circumferential fusion. Preliminary results of two small trials of intra-discal electrotherapy showed conflicting results. Preliminary data from three trials of disc arthroplasty did not permit any firm conclusions. AUTHORS' CONCLUSIONS: Limited evidence is now available to support some aspects of surgical practice. Surgeons should be encouraged to perform further RCTs in this field.

Decompression, Surgical↗

PubMed2005

Surgery for degenerative lumbar spondylosis.

BACKGROUND: Surgical investigations and interventions account for large health care utilisation and costs, but the scientific evidence for most procedures is still limited. OBJECTIVES: Degenerative conditions affecting the lumbar spine are variously described as lumbar spondylosis or degenerative disc disease (which we regarded as one entity) and may be associated with back pain and associated leg symptoms, instability, spinal stenosis and/or degenerative spondylolisthesis. The objective of this review was to assess current scientific evidence on the effectiveness of surgical interventions for degenerative lumbar spondylosis. SEARCH STRATEGY: We searched CENTRAL, MEDLINE, PubMed, Spine and ISSLS abstracts, with citation tracking from the retrieved articles. We also corresponded with experts. All data found up to 31 March 2005 are included. SELECTION CRITERIA: Randomised (RCTs) or quasi-randomised trials of surgical treatment of lumbar spondylosis. DATA COLLECTION AND ANALYSIS: Two authors assessed trial quality and extracted data from published papers. Additional information was sought from the authors if necessary. MAIN RESULTS: Thirty-one published RCTs of all forms of surgical treatment for degenerative lumbar spondylosis were identified. The trials varied in quality: only the more recent trials used appropriate methods of randomization, blinding and independent assessment of outcome. Most of the earlier published results were of technical surgical outcomes with some crude ratings of clinical outcome. More of the recent trials also reported patient-centered outcomes of pain or disability, but there is still very little information on occupational outcomes. There was a particular lack of long term outcomes beyond two to three years. Seven heterogeneous trials on spondylolisthesis, spinal stenosis and nerve compression permitted limited conclusions. Two new trials on the effectiveness of fusion showed conflicting results. One showed that fusion gave better clinical outcomes than conventional physiotherapy, while the other showed that fusion was no better than a modern exercise and rehabilitation programme. Eight trials showed that instrumented fusion produced a higher fusion rate (though that needs to be qualified by the difficulty of assessing fusion in the presence of metal-work), but any improvement in clinical outcomes is probably marginal, while there is other evidence that it may be associated with higher complication rates. Three trials with conflicting results did not permit any conclusions about the relative effectiveness of anterior, posterior or circumferential fusion. Preliminary results of two small trials of intra-discal electrotherapy showed conflicting results. Preliminary data from three trials of disc arthroplasty did not permit any firm conclusions. AUTHORS' CONCLUSIONS: Limited evidence is now available to support some aspects of surgical practice. Surgeons should be encouraged to perform further RCTs in this field.

Decompression, Surgical↗

PubMed2005

Apparent diffusion coefficient and fractional anisotropy in spinal cord: age and cervical spondylosis-related changes.

PURPOSE: To present the apparent diffusion coefficient (ADC) and fractional anisotropy (FA) change with age in the normal spinal cord and in cervical spondylosis. MATERIALS AND METHODS: A total of 11 normal volunteers and 79 cervical spondylosis patients entered this study. Line scan diffusion tensor images were obtained in a 1.5-Tesla whole-body scanner using a phased-array spine coil. The ADC and FA values were measured on a sagittal section. Spearman correlation of ADC/FA vs. age for normal spinal cord was calculated. RESULTS: The mean ADC of the normal spinal cord was 0.81 +/- 0.03 microm(2)/msec at the relatively wide C2-C3 level and 0.75 +/- 0.06 microm(2)/msec at the more narrow C4-C7 level. The FA at the corresponding level was 0.70 +/- 0.05 and 0.66 +/- 0.03, respectively. With age, ADC showed positive correlation (Spearman, r = 0.242) and FA exhibited negative correlation (Spearman, r = -0.244). A total of 54% of all spondylosis cases showed elevated ADC (P < 0.001) and decreased FA (P < 0.001) at the stenotic spinal canal level compared with the normal spinal cord. The average ADC and FA of high-signal lesions on T2-weighted images (seven patients) were 1.28 +/- 0.33 microm(2)/msec and 0.46 +/- 0.12, respectively. CONCLUSION: ADC increases and FA decreases with age in the normal spinal cord. Elevated ADC and reduced FA were measured in the spinal cord of spondylosis cases with clinical symptoms of myelopathy.

Adult↗

PubMed2005

Distinct association of gene polymorphisms of estrogen receptor and vitamin D receptor with lumbar spondylosis in post-menopausal women.

Contribution of genetic backgrounds to the etiology of lumbar spondylosis has been suggested by epidemiological studies. This study was designed to determine the association of restriction fragment length polymorphisms (RFLPs) of estrogen receptor (ER), vitamin D receptor (VDR), parathyroid hormone (PTH) and interleukin-1beta (IL-1beta) genes with the radiological severity of lumbar spondylosis at the disk level from L1/2 to L5/S1 in Japanese post-menopausal women. ER and VDR RFLP haplotypes were associated with the severity of spondylosis in the upper levels (L1/2 and L2/3) more than in the lower levels. Association of ER genotype was more pronounced in the group younger than average than in the older group, while that of VDR genotype was more significant in the older group. Neither PTH nor IL1-beta RFLP was associated with the severity at any levels in either stratified group. We thus conclude that ER and VDR genes may contribute to lumbar spondylosis in a distinct manner: estrogen sensitivity influences the severity in the early phase after menopause while vitamin D plays an important role at older ages when the contribution of estrogen loss is weaker.

Female↗

PubMed2001

A polymorphic variant at the Werner helicase (WRN) gene is associated with bone density, but not spondylosis, in postmenopausal women.

Werner syndrome (WS) is a rare autosomal recessive progeroid syndrome characterized by the premature onset of multiple age-related disorders. The gene responsible for WS has been identified as WRN, a member of the RecQ family of helicase genes. Based on the fact that patients with WS exhibit osteoporosis and osteoarthritis, the present study was undertaken to clarify the contribution of the WRN gene to the etiology of these two common age-related disorders in normal postmenopausal women. We investigated the association of a WRN gene polymorphism, namely c.4330 T --> C leading to an amino acid substitution from Cys to Arg, with bone density and lumbar spondylosis score in unrelated Japanese postmenopausal women (n = 377). Genotypic frequencies of T/T, T/C, and C/C were 87.5%, 12.2%, and 0.3%, respectively. Bone density of the lumbar spine (L2-4) was significantly lower in women carrying the minor C allele than in non-carriers (P = 0.037). When bone density was expressed by the Z score after being adjusted by age and weight, carriers of the C allele showed lower values not only in the lumbar spine, but also in the total body (P = 0.015 and 0.042, respectively). The association study with spondylosis in postmenopausal women (n = 221) revealed that this polymorphism was not related to the severity of spondylosis expressed by the Kellgren-Lawrence score at any disk level of the lumbar spine (L2/3-L5/S1). These findings indicate that the WRN gene may be a candidate for the genetic regulation of osteoporosis, but not spondylosis, in normal Japanese postmenopausal women.

Aged↗

PubMed1991

MRI of the cervical spine: rheumatoid arthritis compared with cervical spondylosis.

This study is a comparison of the cervical spine MR images from 26 patients with rheumatoid arthritis of the cervical spine with those from an age and sex matched group suffering from cervical spondylosis. Erosion of bone and major atlanto-axial subluxation were confined to rheumatoid arthritis. Soft tissue changes revealed by MRI included distortion of normal ligaments and bursae around the dens, particularly in rheumatoid arthritis. Abnormal masses of soft tissue were found in both groups, but those suggesting acute inflammation were much more frequent in rheumatoid arthritis than in cervical spondylosis. Neural compression was well demonstrated, and in rheumatoid arthritis was usually caused by bony structures whereas in cervical spondylosis it was usually due to disc material. It is concluded that MRI should be used as the first investigation to follow plain films in rheumatoid arthritis of the cervical spine. Bone and soft tissue changes are clearly shown, but interpretation of the images requires the recognition that some observed abnormalities may be due to coincidental cervical spondylosis.

Adult↗