요추부 척추관 협착증을 가진 50세 이상 여자 환자의 골다공증 또는 슬관절 퇴행성 관절염의 유병율 = The Prevalence of Osteoporosis or Degenerative Osteoarthritis of Knee in Female Patients with Lumbar Spinal Stenosis Over 50 Years

다국어 초록 (Multilingual Abstract)

Objective: To evaluate the prevalence of osteoporosis and degenerative knee osteoarthritis (OA) in female patients over 50 years, who were surgically indicated for lumbar spinal stenosis (LSS).
Methods: The study subjects were 76 female patients who underwent spinal surgery for LSS between January and December 2006. Radiographs of thoracolumbar spine, hip and knee were taken. Osteoporotic profiles including lumbar and hip bone mineral density (BMD) measurements and proper treatment of osteoporosis were investigated.
Results: The mean age was 65.1 (50~86) years old. Seven-teen patients (22.4%) and nine-teen patients (25.0%) had spine and hip BMD below a T score of -2.5. Thirty-two patients (48.0%) and four patients (5.2%) had knee and hip OA of K-L grade III and IV each. Old thoracolumbar osteoporotic compression fractures were confirmed in 6patients (7.8%). Forty-eight percent (48.0%) of enrolled patients had hypovitaminosis D. According to osteoporosis guidelines from the Korean Society of Bone Metabolism, 31 patients (40.7%) qualified to be candidates of intensive osteoporosis treatments.
Conclusion: The prevalence of osteoporosis and knee OA in LSS patients was 25.0% and 42.1%. Based on checking up BMD and knee OA in female patient with LSS, proper treatments of osteoporosis and degenerative knee OA should be considered. [Korean Journal of Bone Metabolism, 18(1): 33-38, 2011]

국문 초록 (Abstract)

연구목적: 요추부 척추관 협착증에 대해 수술적 치료를 받은 50세 이상 여성에서 골다공증 및 슬관절 퇴행성 관절염의유병율을 알아보고자 하였다.
연구방법: 2006년 1월부터 12월까지 척추관 협착증으로 수술 받은 76명의 여성 환자에서 체질량지수, 방사선 사진 (흉요추, 고관절, 슬관절), 골밀도 측정을 실시하였다.
결 과: 대상자 평균 연령은 65.1 (50~86)세였고, 골다공증 진단은 요추 기준 17명 (22.4%), 고관절 기준 19명 (25.0%)이었다. K-L grade III 이상의 퇴행성 관절염이 슬관절 32명 (42.1%)과 고관절 4명 (5.2%)에서 관찰되었다. 진구성 골다공증성 척추골절은 6명 (7.8%)에서 발견되었다. 대상 환자의 48%에서 비타민 D 결핍증이 있었다. 대한골대사학회 치료기준에 의하면 전체 환자의 40.7%인 31명의 환자는 전문적인 골다공증 치료를 해야 하는 대상군이었다.
결 론: 요추부 척추관 협착증 환자에서 골다공증의 유병율은 25.0%였으며, 슬관절 퇴행성 관절염의 유병율은 42.1%였다. 따라서 척추관 협착증을 가진 여성 환자는 골밀도 및 슬관절 퇴행성 관절염 검사가 필요하며, 치료기준에 따라 골다공증 및 슬관절 퇴행성 관절염의 전문적인 치료가 병행되어야 하겠다.

참고문헌 (Reference)

1 김영일, "울산지역에서 주폐경기 (Perimenopause) 여성의 골다공증 유병률과 연관인자" 대한내과학회 62 (62): 2-24, 2002

2 Bouillon R, "Vitamin D deficiency in the elderly, In Nutritional aspects of osteoporosis Serono Symposium 85" Raven Press 245-256, 1991

3 Lips P, "Vitamin D deficiency and secondary hyperparathyroidism in the elderly: consequences for bone loss and fractures and therapeutic implications" 22 : 477-501, 2001

4 Margulies JY, "The relationship between degenerative changes and osteoporosis in the lumbar spine" 324 : 145-152, 1996

5 Makinen TJ, "The incidence of osteopenia and osteoporosis in women with hip osteoarthritis scheduled for cementless total joint replacement" 40 : 1041-1047, 2007

6 김인제, "The Prevalence of Knee Osteoarthritis in Elderly Community Residents in Korea" 대한의학회 25 (25): 293-298, 2010

7 Truumees E, "Spinal stenosis: pathophysiology, clinical and radiologic classification" 54 : 287-302, 2005

8 Malabanan A, "Redefining vitamin D insufficiency" 351 : 805-806, 1998

9 WHO Scientific Group, "Prevention and management of osteoporosis" 921 : 1-164, 2003

10 Kim CH, "Prevalence of osteoporosis in jung-up district Korea" 4 : 65-71, 1997

11 Shin A, "Prevalence and risk factors of distal radius and calcaneus bone mineral density in Korean population" SPRINGER LONDON LTD 15 : 639-644, 2004

12 National Osteoporosis Foundation, "Physician's guide to prevention and treatment of osteoporosis" National Osteoporosis Foundation 2000

13 National Institutes of Health, "Osteoporosis prevention, diagnosis, and therapy" 285 : 785-795, 2001

14 Verstraeten A, "Osteoarthrosis retards the development of osteoporosis. Observation of the coexistence of osteoarthrosis and osteoporosis" 169-177, 1991

15 Cooper C, "Osteoarthritis of the hip and osteoporosis of the proximal femur" 50 : 540-542, 1991

16 Dequeker J, "Osteoarthritis and osteoporosis: clinical and research evidence of inverse relationship" 15 : 426-439, 2003

17 Kellgren JH, "Osteo-arthrosis and disk degeneration in an urban population" 17 : 388-397, 1958

18 World Health Organization, "Obesity: preventing and managing the global epidemic. Report of a WHO Consultation on Obesity. 3~5 June 1997" World Health Organization 1998

19 Holick MF, "McCollum Award Lecture, 1994: vitamin D--new horizons for the 21st century" 60 : 619-630, 1994

20 Silberberg R, "Histologic and morphometric observations on vertebral bone of aging sand rats" 13 : 202-208, 1988

21 Riggs BL, "Differential changes in bone mineral density of the appendicular and axial skeleton with aging: relationship to spinal osteoporosis" 67 : 328-335, 1981

22 Renier JC, "Correlation between osteoporosis and discarthrosis. Comparative frequency of spinal osteophytosis and thickness of intervertebral disk in 50 patients with osteoporosis confirmed by bone biopsy and in 50 controls. Study of lordosis in 50 osteoporotic patients" 48 : 323-330, 1981

23 United States Public Health Service, Surgeon General of the United States, "Bone health and osteoporosis: a report of the surgeon general" Office of the Surgeon General (US) 2004

24 Foss MV, "Bone density, osteoarthrosis of the hip, and fracture of the upper end of the femur" 31 : 259-264, 1972

25 Radin EL, "A comparison of the dynamic force transmitting properties of subchondral bone and articular cartilage" 52 : 444-456, 1970