Degenerative Veränderungen der zervikalen Facettengelenke sowie der medialen und lateralen atlantoaxialen Gelenke - eine paläopathologische Studie

 

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Zusammenfassung

Studienziel: Die paläopathologische Studie beschreibt die Häufigkeit und den Schweregrad von degenerativen Veränderungen der zervikalen Facettengelenke sowie der medialen und lateralen atlantoaxialen Gelenke. Material und Methodik: Die Untersuchung wurde an 196 Halswirbelsäulen aus dem Südwesten von Deutschland (6.-8. Jahrhundert n. Chr.) vorgenommen. Degenerative Veränderungen wurden unterteilt in marginale Osteophyten (Grad 1), unebene oder perforierte Gelenkoberfläche (Grad 2) sowie knöcherne Fusion (Grad 3). Ergebnisse: 19,4 % der Skelette zeigten degenerative Veränderungen der zervikalen Facettengelenke und/oder atlantoaxialen Gelenke (durchschnittliches Sterbealter: 44 Jahre). Der mediale (6,1 %) und laterale (0,6 %) Anteil der atlantoaxialen Gelenke war selten degenerativ verändert. Die Facettengelenke von HWK 3-4 bis HWK 6-7 zeigten degenerative Veränderungen in 8,0-11,7 % (normalerweise Grad 1 und 2). Das Facettengelenk HWK 2-3 zeigte signifikant häufiger degenerative Veränderungen (19,7 %, p < 0,05), dabei wird in einem Viertel der Fälle eine knöcherne Fusion (Grad 3) beobachtet. Schlussfolgerung: Auffallend ist die häufige degenerative Veränderung der Facettengelenke HWK 2-3.

Abstract

Aim: This article describes the prevalence of degenerative changes of the upper cervical spine (C1-C2) and cervical facet joints found during investigations of spinal column remains. Materials and Methods: This study was conducted on a sample of 196 cervical spines from southwestern Germany which derive from the 6th to 8th centuries AD. The degenerative lesions were classified into grades 1 (marginal osteophytes), 2 (uneven joint surfaces), or 3 (osseous ankylosis). Results: Of the skeletons examined, 19.4 % (n = 38) showed degenerative changes of the cervical facet joints and/or upper cervical spine (mean age at death was 44 years). The medial (6.1 %) and lateral (0.6 %) atlanto-axial joints were rarely involved in degenerative changes. The facet joints from C3-C4 to C6-C7 showed degenerative changes in 8.0-11.7 % of cases (usually grade 1 and 2). The C2-C3 facet joints were significantly involved in degenerative changes in 19.7 % of cases, one fourth of which were osseous ankylosis (grade 3). Conclusion: The C2-C3 facet joints showed a high rate of degenerative changes.

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Dr. Jochen Weber

Neurochirurgische Klinik, Leopoldina KH

Gustav-Adolf-Str. 8

97422 Schweinfurt

Phone: 0 97 21/7 20 26 26

Fax: 0 97 21/7 20 29 92

Email: jweber@leopoldina.de