Gutke Annelie, Hansson Eva Roos, Zetherström Gunilla, Ostgaard Hans Christian
Division of Physiotherapy, Department of Medicine and Health Sciences, Linköping University, Linköping, Sweden.
Eur Spine J. 2009 Jul;18(7):1008-12. doi: 10.1007/s00586-009-1003-z. Epub 2009 Apr 24.
The classification of pelvic girdle pain can only be reached after lumbar causes have been excluded by a clinical examination. During clinical examination, the posterior pelvic pain provocation test is a well-established method for verifying pelvic girdle pain. However, a criticism of pelvic pain provocation tests is that they may have an effect on lumbar structures, thus yielding false-positive results. The posterior pelvic pain provocation test was performed with four groups of patients: patients with computed tomography-verified disc herniations (1) on the waiting list for surgery (14 women; 9 men); (2) 6 weeks after disc surgery (18 women, 12 men); (3) pregnant women seeking care for pelvic girdle pain (n = 25); and (4) women with persistent pelvic girdle pain after delivery (n = 32). The sensitivity of the posterior pelvic pain provocation test was 0.88 and the specificity was 0.89. The positive predictive value was 0.89 and the negative predictive value was 0.87. Analysis of only women showed similar results. In our study, the posterior pelvic pain provocation test was negative in patients with a well-defined lumbar diagnosis of lumbar disc herniation, both before and after disc surgery. Our results are an important step toward the more accurate classification of lumbopelvic pain.
只有在通过临床检查排除腰椎病因后，才能对骨盆带疼痛进行分类。在临床检查期间，骨盆后疼痛激发试验是验证骨盆带疼痛的一种成熟方法。然而，对骨盆疼痛激发试验的一种批评是，它们可能会对腰椎结构产生影响，从而产生假阳性结果。对四组患者进行了骨盆后疼痛激发试验：（1）等待手术的计算机断层扫描证实椎间盘突出症患者（14名女性；9名男性）；（2）椎间盘手术后6周的患者（18名女性，12名男性）；（3）因骨盆带疼痛寻求护理的孕妇（n = 25）；以及（4）分娩后持续骨盆带疼痛的女性（n = 32）。骨盆后疼痛激发试验的敏感性为0.88，特异性为0.89。阳性预测值为0.89，阴性预测值为0.87。仅对女性进行分析显示了类似的结果。在我们的研究中，对于明确诊断为腰椎间盘突出症的患者，无论在椎间盘手术前后，骨盆后疼痛激发试验均为阴性。我们的结果是朝着更准确地分类腰骨盆疼痛迈出的重要一步。
