Journal of Korean Society of Spine Surgery (대한척추외과학회지)

Korean Society of Spine Surgery (대한척추외과학회)
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Concurrent Degenerative Cervical and Lumbar Spondylolisthesis

경추 및 요추 퇴행성 척추전위증의 병발성 유병률

  • Park, Moon Soo (Department of Orthopaedic Surgery, Hallym University Sacred Heart Hospital, Medical College of Hallym University) ;
  • Hwang, Ji-Hyo (Department of Orthopaedic Surgery, Hallym University Sacred Heart Hospital, Medical College of Hallym University) ;
  • Kim, Tae-Hwan (Department of Orthopaedic Surgery, Gangnam Sacred Heart Hospital, Hallym University College of Medicine) ;
  • Oh, Jae Keun (Department of Orthopaedic Surgery, Hallym University Sacred Heart Hospital, Medical College of Hallym University) ;
  • Chang, Ho Guen (Department of Neurosurgery, Hallym University Sacred Heart Hospital, Medical College of Hallym University) ;
  • Kim, Hyung Joon (Department of Orthopaedic Surgery, Hallym University Sacred Heart Hospital, Medical College of Hallym University) ;
  • Park, Kun-Tae (Department of Orthopaedic Surgery, Hallym University Sacred Heart Hospital, Medical College of Hallym University) ;
  • Lim, Jin Kyu (Department of Orthopaedic Surgery, Kangdong Sacred Heart Hospital, Medical College of Hallym University) ;
  • Riew, K. Daniel (Department of Orthopedic Surgery, Columbia University Medical Center / NY-Presbyterian Hospital, The Spine Hospital at NY-Presbyterian/Allen Hospital)
  • 박문수 (한림대학교 한림대학교성심병원 정형외과학교실) ;
  • 황지효 (한림대학교 한림대학교성심병원 정형외과학교실) ;
  • 김태환 (한림대학교 강남성심병원 정형외과학교실) ;
  • 오재근 (한림대학교 한림대학교성심병원 정형외과학교실) ;
  • 장호근 (한림대학교 한림대학교성심병원 신경외과학교실) ;
  • 김형준 (한림대학교 한림대학교성심병원 정형외과학교실) ;
  • 박건태 (한림대학교 한림대학교성심병원 정형외과학교실) ;
  • 임진규 (한림대학교 강동성심병원 정형외과학교실) ;
  • Received : 2018.10.14
  • Accepted : 2018.11.19
  • Published : 2018.12.30
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Abstract

Study Design: Retrospective radiographic study. Objective: To evaluate the characteristics of concurrent degenerative cervical and lumbar spondylolisthesis. Summary of Literature Review: Concurrent degenerative cervical and lumbar spondylotic diseases have been reported. Given that severe spondylosis can result in spondylolisthesis, one might expect that concurrent spondylolisthesis of the cervical and lumbar spines might also be prevalent. However, the incidence of spondylolistheses in the lumbar and cervical spines might differ due to anatomical differences between the 2 areas. Nonetheless, there is minimal information in the literature concerning the incidence of concurrent cervical and lumbar spondylolisthesis. Material and Methods: We evaluated standing cervical and lumbar lateral radiographs of 2510 patients with spondylosis. Concurrence, age group, gender, and direction of spondylolisthesis were evaluated. Lumbar spondylolisthesis was defined as at least Meyerding grade I and degenerative cervical spondylolisthesis was defined as over 2 mm of displacement on standing lateral radiographs. Results: Lumbar spondylolisthesis was found in 125 patients (5.0%) and cervical spondylolisthesis was found in 193 patients (7.7%). Seventeen patients had both degenerative cervical and lumbar spondylolistheses (0.7%). Lumbar spondylolisthesis is a risk factor for coexisting cervical spondylolisthesis. Lumbar spondylolisthesis was more common in females than males, independent of advancing age. In contrast, degenerative cervical spondylolisthesis was more common in older patients, independent of gender. Anterolisthesis was more common in the lumbar spine. Retrolisthesis was more common in the cervical spine. Conclusions: There was a higher prevalence of degenerative cervical spondylolisthesis in patients with degenerative lumbar spondylolisthesis.

연구 계획: 후향적 방사선 연구 목적: 경추와 요추에 동시에 발생한 퇴행성 척추전위증을 알아보고자 한다. 선행 연구논문의 요약: 경추와 요추에 동시에 발생한 퇴행성 척추질환에 대한 여러 보고가 있었다. 퇴행성 척추전위증은 퇴행성 변화에 의하여 시발되므로 경추와 요추에 척추전위증이 병발할 것으로 추정된다. 반면에, 요추와 경추의 해부학적 구조가 서로 다르므로 두 질환의 진행이 동일하지 않을 것으로 추정할 수도 있다. 그러나, 경추와 요추에 동시에 발생한 퇴행성 척추전위증에 대한 보고는 적었다. 대상 및 방법: 요추 및 경추 부위에 기립위 단순방사선 검사를 둘다 시행한 퇴행성 척추 질환 환자 2,510명을 대상으로 하였다. 병발여부, 나이, 성별, 전위증의 방향에 대하여 조사하였다. 퇴행성 요추전위증은 기립위 단순방사선영상에서 Meyerding 방법을 사용하여 grade 1 이상인 경우 진단하였으며 퇴행성 경추전위증은 기립위 단순방사선영상에서 2 mm 이상의 전위가 보이는 경우 진단하였다. 결과: 퇴행성 요추전위증은 125명에서 관찰되었으며(5.0%) 퇴행성 경추전위증은 193명에서 관찰되었다(7.7%). 요추전위증과 경추전위증은 17명에서 같이 관찰되었다(0.7%). 요추전위증이 있는 환자가 없는 환자에 비하여 경추전위증이 더 많이 관찰되었다. 요추전위증은 남자보다 여자에서 더 흔하였으나, 모든 연령군에서 비슷하게 발생하였다. 경추전위증은 고령의 연령군에서 더 많이 발생하였으나, 남녀의 발생 비율이 비슷하였다. 요추전위증에서는 전방으로 많이 발생하였고, 경추전위증에서는 후방으로 많이 발생하였다. 결론: 퇴행성 요추전위증이 있는 경우가 없는 경우에 비하여 퇴행성 경추전위증이 더 많이 발생하였다.

Keywords

References

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