Article

The intervertebral disk is the largest avascular structure in the
body. It relies on passive diffusion from arteries at the periphery of the disk
for nutrition. Previous studies have suggested a correlation between vascular
disease and lumbar degenerative disk disease (DDD), but the association with
facet arthritis and stenosis has not been evaluated.
OBJECTIVE: To evaluate the
degree of lumbar artery stenosis, aortic atherosclerosis on computed tomography
angiography, and its relationship to lumbar DDD, facet arthritis, and spinal
canal stenosis. DESIGN: Retrospective case review. SETTING: Academic tertiary
care hospital. PARTICIPANTS: Not applicable. METHODS:
A total of 300 lumbar
arteries (150 lumbar artery pairs of the first to fifth lumbar arteries) were
evaluated on consecutive computed tomography angiography scans. Severity of
vascular disease of lumbar arteries was documented as normal, mild, moderate,
severe, or occluded. Aortic vascular disease was documented along the posterior
wall where the lumbar arteries originate. MAIN OUTCOME MEASUREMENTS: The
relationship between vascular disease with DDD, facet arthritis, and spinal canal
stenosis was examined and further evaluated controlling for age. RESULTS: Lumbar
artery and aortic atherosclerosis had a positive relationship with DDD, facet
arthritis, and spinal stenosis that was statistically significant (P < .05) even
after controlling for age. The correlation coefficient was greatest in the
younger age group when looking at lumbar artery vascular disease with DDD (0.73,
confidence interval 0.50-0.96, P < .0001) and aortic vascular disease with DDD
(0.72, confidence interval 0.49-0.94, P < .0001).
The correlation of vascular
disease with facet arthritis and stenosis was not strong in the older age group.
CONCLUSION: Atherosclerotic disease of the lumbar arteries and aorta correlated
with lumbar DDD, facet arthritis, and spinal canal stenosis after we adjusted for
age, although the correlation with facet arthritis and spinal canal stenosis was
not as strong in the older age group. LEVEL OF EVIDENCE: IV.
CI - Copyright (c) 2018 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS