Gremeaux Vincent, Casillas Jean-Marie, Fabbro-Peray Pascale, Pelissier Jacques, Herisson Christian, Perennou Dominic
Pôle Rééducation-Réadaptation, University Hospital Dijon, 23 rue Gaffarel, 21079 Dijon Cedex, France.
Spine (Phila Pa 1976). 2008 Feb 15;33(4):402-5. doi: 10.1097/BRS.0b013e318163fa42.
Prospective study of self-assessed symptom severity.
To carry out a comparative semiological analysis of pain in scoliotic and nonscoliotic adults with low back pain, and to study the factors that correlate with the severity of pain in scoliotic patients.
Low back pain is a frequent complaint in subjects with adult lumbar scoliosis. Few studies have taken an interest in the semiological specificities of lumbar pain in such patients.
Fifty adults with lumbar scoliosis and suffering from chronic low back pain and 50 nonscoliotic adults with chronic low back pain, matched for age and gender underwent a standard examination. The characteristics of the pain described in the 2 groups were compared. Relationships between the features of the scoliosis and the intensity of the pain were sought.
There was no difference between the 2 groups with regard to pain severity (duration and intensity). The pain evolved more steadily in scoliotic patients. Inguinal pain (P < 0.001) and cruralgia (P < 0.05) were particularly associated with scoliosis. In scoliotics, the severity of the low back pain correlated well with the radiologic aspects: Cobb angle (P < 0.05), vertebral rotation (P < 0.05) and rotatory olisthesis (P < 0.05). Cruralgia was significantly associated with the presence of rotatory dislocation (P < 0.01).
The pain felt by scoliotic adults has several semiological features, in particular the frequency of inguinal pain and cruralgia. Lumbar scoliosis with a great curvature and/or rotatory olisthesis increases the intensity of low back pain in adults. These findings suggest that the magnitude of the curvature and the existence of rotatory olisthesis must be targeted for prevention and treatment of the chronic low back pain in subjects with a lumbar scoliosis.
对自我评估的症状严重程度进行前瞻性研究。
对患有腰痛的脊柱侧弯和非脊柱侧弯成年人的疼痛进行比较性症状学分析，并研究与脊柱侧弯患者疼痛严重程度相关的因素。
腰痛是成年腰椎脊柱侧弯患者的常见主诉。很少有研究关注此类患者腰痛的症状学特异性。
50名患有慢性腰痛的成年脊柱侧弯患者和50名年龄及性别匹配的患有慢性腰痛的非脊柱侧弯成年患者接受了标准检查。比较两组所描述疼痛的特征。探寻脊柱侧弯特征与疼痛强度之间的关系。
两组在疼痛严重程度（持续时间和强度）方面无差异。脊柱侧弯患者的疼痛发展更为稳定。腹股沟疼痛（P < 0.001）和小腿痛（P < 0.05）与脊柱侧弯尤其相关。在脊柱侧弯患者中，腰痛的严重程度与放射学表现密切相关：Cobb角（P < 0.05）、椎体旋转（P < 0.05）和旋转性椎体滑移（P < 0.05）。小腿痛与旋转性脱位的存在显著相关（P < 0.01）。
脊柱侧弯成年人所感受到的疼痛具有多种症状学特征，尤其是腹股沟疼痛和小腿痛的发生率。具有较大弯曲度和/或旋转性椎体滑移的腰椎脊柱侧弯会增加成年人腰痛的强度。这些发现表明，在预防和治疗腰椎脊柱侧弯患者的慢性腰痛时，必须针对弯曲度大小和旋转性椎体滑移的存在情况。
