Department of Trauma and Orthopaedics, Thriasio General Hospital-NHS, Attica, Greece.
J Clin Rheumatol. 2010 Mar;16(2):55-60. doi: 10.1097/RHU.0b013e3181cf3527.
In contrast to what was believed in the past, nonspecific low back pain is a fairly frequent condition in children, whose pathophysiology remains unclear as yet. Although many factors have been implicated in its development, results are often contradictory.
Our study aims to examine most of the reasons investigated in the international literature, as well as the previously unexamined impact of passive smoking in its clinical appearance. It is a retrospective study that investigates the symptom of nonspecific low back pain during a 12-month period before the visit of children to our department. The research included 692 children aged 7.5 to 14 years. The data were collected using a semi-structured questionnaire, which included a mix of open and closed questions, followed by physical examination during their visit.
A total of 153 children were considered to present nonspecific low back pain during the previous year. The determinant factors appear to be greater age, the male sex, larger height, increased weight, dissatisfaction with school chairs, the clinical presentation of back pain in at least 1 parent, and coexisting anatomic orthopedic conditions. On the contrary, the weight of the school bag, the way in which it was carried and participation in sports, as well as the time spent by children in front of the TV or PC playing video or play station games, did not appear to have a statistically significant correlation with its appearance. In general, passive smoking does not appear to be a risk factor (P[r] = 0.341), and does not seem to play a leading role in the etiology of the condition. Furthermore, even the heaviness of parental smoking (over 20 cigarettes a day) does not seem to alter the appearance of the disease. The effect of nonspecific low back pain in children's activities was measured using Hannover Functional Ability and Rolland Morris questionnaires, appropriately modified to childhood, where he found a moderate or severe restriction of activity in 23.52% (score >5) and 19.61% (score >6), respectively.
The data analysis shows that nonspecific low back pain in children is a benign disorder with an unknown pathophysiological mechanism. Many anthropometric characteristics and environmental factors are implicated, but to a different degree each time. Passive smoking as well as the heaviness thereof does not appeal to play in important role in its clinical presentation. Further investigation is deemed necessary to determine the existence of other risk factors, as well as the level of their participation in the condition's pathophysiology.
与过去的观点相反，非特异性下腰痛在儿童中较为常见，但目前其病理生理学仍不清楚。尽管许多因素与该病的发生有关，但结果往往相互矛盾。
我们的研究旨在检验国际文献中已提出的大部分病因，以及以前未研究过的被动吸烟对该病临床表现的影响。这是一项回顾性研究，调查了儿童到我科就诊前 12 个月内非特异性下腰痛的症状。该研究纳入了 692 名 7.5 至 14 岁的儿童。研究数据通过半结构式问卷收集，问卷中包含了开放式和封闭式问题，随后在儿童就诊时进行了体格检查。
共有 153 名儿童在过去一年中出现非特异性下腰痛。具有决定意义的因素似乎是年龄较大、男性、身高较高、体重增加、对学校椅子不满意、至少有 1 名家长有背痛病史，以及并存解剖学骨科疾病。相反，书包的重量、携带方式以及参与运动的情况，以及儿童在电视或 PC 前玩视频或游戏的时间，与该病的出现似乎没有统计学上的显著相关性。一般来说，被动吸烟似乎不是一个危险因素（P[r]=0.341），并且在该病的病因学中似乎没有起主要作用。此外，即使父母吸烟量较大（每天超过 20 支香烟）也似乎不会改变疾病的出现。通过适当修改为儿童使用的汉诺威功能能力和罗尔丹·莫里斯问卷来测量非特异性下腰痛对儿童活动的影响，发现 23.52%（评分>5）和 19.61%（评分>6）的儿童活动受到中度或严重限制。
数据分析表明，儿童非特异性下腰痛是一种良性疾病，其病理生理学机制尚不清楚。许多人体测量特征和环境因素都与该病有关，但每次的关联程度不同。被动吸烟及其严重程度似乎在其临床表现中没有起到重要作用。需要进一步研究以确定其他危险因素的存在及其在该病病理生理学中的参与程度。
