Shiri Rahman, Karppinen Jaro, Leino-Arjas Päivi, Solovieva Svetlana, Varonen Helena, Kalso Eija, Ukkola Olavi, Viikari-Juntura Eira
Musculoskeletal Disorders, Finnish Institute of Occupational Health, Topeliuksenkatu 41a A, 00250, Helsinki, Finland.
Eur Spine J. 2007 Dec;16(12):2043-54. doi: 10.1007/s00586-007-0362-6. Epub 2007 May 25.
Lumbar radicular pain is a fairly common health problem, yet its risk factors are far from clear. There are no published systematic reviews on associations between cardiovascular or lifestyle risk factors and lumbar radicular pain or sciatica. The aim of this systematic literature review was to assess associations between these risk factors and lumbar radicular pain or sciatica. We conducted a systematic search of the Medline database for all original articles on lumbar radicular pain or sciatica published until August 2006. Twenty-two papers from 19 studies were included in the review. Overweight or obesity was associated with sciatica in most of the case-control and cohort studies. Some studies showed an increased risk of lumbar radicular pain in smokers with a long smoking history or in those with high levels of physical activity. A few case-control studies showed an association between serum C-reactive protein and sciatica. No consistent associations were found for serum lipids levels or high blood pressure. In summary, the associations of overweight, long smoking history, high physical activity and a high serum C-reactive protein level with lumbar radicular pain or sciatica were substantiated by the present review. However, more prospective studies are needed in order to further clarify these associations and the mechanisms of action.
腰椎神经根性疼痛是一种相当常见的健康问题,但其危险因素远未明确。目前尚无已发表的关于心血管或生活方式危险因素与腰椎神经根性疼痛或坐骨神经痛之间关联的系统评价。本系统文献综述的目的是评估这些危险因素与腰椎神经根性疼痛或坐骨神经痛之间的关联。我们对Medline数据库进行了系统检索,查找截至2006年8月发表的所有关于腰椎神经根性疼痛或坐骨神经痛的原创文章。本综述纳入了19项研究中的22篇论文。在大多数病例对照研究和队列研究中,超重或肥胖与坐骨神经痛相关。一些研究表明,吸烟史长的吸烟者或体育活动量高的人群患腰椎神经根性疼痛的风险增加。少数病例对照研究显示血清C反应蛋白与坐骨神经痛之间存在关联。未发现血脂水平或高血压与腰椎神经根性疼痛或坐骨神经痛之间存在一致的关联。总之,本综述证实了超重、吸烟史长、体育活动量高和血清C反应蛋白水平高与腰椎神经根性疼痛或坐骨神经痛之间的关联。然而,需要更多的前瞻性研究来进一步阐明这些关联及其作用机制。