Dickey James P, Pierrynowski Michael R, Bednar Drew A, Yang Simon X
Department of Human Biology and Nutritional Sciences, University of Guelph, Ont., Canada N1G 2W1.
Clin Biomech (Bristol). 2002 Jun;17(5):345-52. doi: 10.1016/s0268-0033(02)00032-3.
To investigate the relationship between intervertebral motion, intravertebral deformation and pain in chronic low-back pain patients.
This study measured vertebral motion of the lumbar spine and associated pain in a select group of chronic low-back pain patients as they performed a standard battery of motions in all planes.
Numerous studies have demonstrated that individuals with low-back pain have impaired spinal motion, yet few studies have examined the specific relationship between pain and motion parameters. Although it is accepted that the pain in mechanical low-back patients is due to specific spinal motions, no studies have related specific motions to pain measures.
Percutaneous intra-pedicle screws were placed into the right and left L4 (or L5) and S1 segments of nine chronic low-back pain patients. The external fixator frame was removed following the clinical external fixation test. The 3D locations of the pedicle screws and the level of pain were recorded as the subjects performed a battery of motions. The relationship between the pain and motion parameters was assessed using linear discriminant analysis and neural network models.
The neural network model showed a strong relationship between observed and predicted pain (R(2)=0.997). The discriminant analysis showed a weak relationship (R(2)=0.5).
Vertebral motion parameters are strongly predictive of pain in this select group of chronic low-back pain patients. The nature of the relationship is nonlinear and involves interactions; neural networks are able to effectively describe these relationships.
Specific patterns of intervertebral motion and intravertebral deformation result in pain in chronic low-back pain patients. This substantiates the mechanical back pain aetiology.
研究慢性下腰痛患者的椎间运动、椎体内变形与疼痛之间的关系。
本研究测量了一组特定慢性下腰痛患者在进行所有平面的标准动作组时腰椎的椎体运动及相关疼痛情况。
众多研究表明下腰痛患者存在脊柱运动功能受损，但很少有研究考察疼痛与运动参数之间的具体关系。虽然普遍认为机械性下腰痛患者的疼痛是由特定脊柱运动引起的，但尚无研究将特定运动与疼痛测量相关联。
对9名慢性下腰痛患者的左右L4（或L5）和S1节段经皮置入椎弓根螺钉。临床外固定试验后拆除外固定架。在受试者进行一系列动作时记录椎弓根螺钉的三维位置和疼痛程度。使用线性判别分析和神经网络模型评估疼痛与运动参数之间的关系。
神经网络模型显示观察到的疼痛与预测的疼痛之间存在很强的关系（R(2)=0.997）。判别分析显示关系较弱（R(2)=0.5）。
在这组特定的慢性下腰痛患者中，椎体运动参数对疼痛有很强的预测性。这种关系的性质是非线性的且涉及相互作用；神经网络能够有效描述这些关系。
椎间运动和椎体内变形的特定模式导致慢性下腰痛患者疼痛。这证实了机械性背痛的病因。
