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
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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.
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]
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