척추 및 슬관절의 퇴행성 변화와 요추 골밀도의 상관관계

Abstract

Background: Osteoporosis and primary osteoarthritis (OA) are both common condition in elderly women. Many studies demonstrated an inverse correlation between osteoporosis and OA. OA of the knee appears to increase bone mineral density (BMD) while increasing the risk of vertevral and non vertebral fracture. Nevertheless. combine effect of the current study was to evaluate the effect of degenerative changes of the spine and knee on lumbar BMD and prevalent osteoporoic vertebral fracture.

Meterials and Methods: One hundred ninty six postmenopausal women (mean 65 years old, range from 52 to 87 years old) were included in the study. standard anterior-posterior and lateral radiographs of the spine were taken in standardized manner. standing anterior-posterior radiograph of the knee was also taken. Lumbar BMD was measured with dual energy X-ray absorptiometry. The degenerative change of the lumbar spine were scored with qualitative and quantiative critera (0 to 28 points). The degenerative change of the knee were graded by Kellgren-Lawrence method (grade 0 to 4). Prevalent vertebral fractures were identified by morphometric assessment.

Results: There was a significant correlation of degenerative scores of the lumbar spine and Kellgren-Lawrence grade of the knee. In multiple regression analysis including age, height, body weight, menopaise, degenerative score of the spine, and Kellgren-Lawrence grade of the knee on lumbar BMD (partial R²=0.406, p=0.014: partial R²=0.393, p=0.021). Patients with spinal OA (score, 5<) exhibited low rate of prevalent vertebral fracture (p<0.05), while those with knee OA (Kellgren-Lawrence grade 2≤) showed no significant changes in the rate of prevalent vertebral fracture.

Conclusion: OAs of the spine and knee appear to increase lumbar BMD and OA of the spine, not OA of the knee, appears to render protective effect on osteoporotic vertebral fractures.