Department of Orthopedic Surgery, Niigata Prefectural Shibata Hospital, Shibata, Japan.
Eur Spine J. 2011 Feb;20(2):274-9. doi: 10.1007/s00586-010-1657-6. Epub 2010 Dec 17.
There have been a few studies regarding detail of back pain in adolescents with idiopathic scoliosis (IS) as prevalence, location, and severity. The condition of back pain in adolescents with IS was clarified based on a cross-sectional study using a questionnaire survey, targeting a total of 43,630 pupils, including all elementary school pupils from the fourth to sixth grade (21,893 pupils) and all junior high pupils from the first to third year (21,737 pupils) in Niigata City (population of 785,067), Japan. 32,134 pupils were determined to have valid responses (valid response rate: 73.7%). In Niigata City, pupils from the fourth grade of elementary school to the third year of junior high school are screened for scoliosis every year. This screening system involves a three-step survey, and the third step of the survey is an imaging and medical examination at the Niigata University Hospital. In this study, the pupils who answered in the questionnaire that they had been advised to visit Niigata University Hospital after the school screening were defined as Scoliosis group (51 pupils; 0.159%) and the others were defined as No scoliosis group (32,083 pupils). The point and lifetime prevalence of back pain, the duration, the recurrence, the severity and the location of back pain were compared between these groups. The severity of back pain was divided into three levels (level 1 no limitation in any activity; level 2 necessary to refrain from participating in sports and physical activities, and level 3 necessary to be absent from school). The point prevalence was 11.4% in No scoliosis group, and 27.5% in Scoliosis group. The lifetime prevalence was 32.9% in No scoliosis group, and 58.8% in Scoliosis group. According to the gender- and school-grade-adjusted odds ratios (OR), Scoliosis group showed a more than twofold elevated odds of back pain compared to No scoliosis group irrespective of the point or lifetime prevalence of back pain (OR, 2.29; P = 0.009 and OR, 2.10; P = 0.012, respectively). Scoliosis group experienced significantly more severe pain, and of a significantly longer duration with more frequent recurrences in comparison to No scoliosis group. Scoliosis group showed significantly more back pain in the upper and middle right back in comparison to No scoliosis group. These findings suggest that there is a relationship between pain around the right scapula in Scoliosis group and the right rib hump that is common in IS.
已有一些研究探讨了特发性脊柱侧凸（IS）青少年的背痛细节，如患病率、位置和严重程度。本研究基于一项横断面问卷调查，共调查了日本新潟市 43630 名小学生和初中生，包括四年级至六年级的所有小学生（21893 人）和一年级至三年级的所有初中生（21737 人）。32134 名学生的回答被认为是有效的（有效应答率：73.7%）。在新潟市，每年都会对小学生和初中生进行脊柱侧凸筛查。该筛查系统采用三步法，第三步是在新潟大学医院进行影像学和医学检查。在这项研究中，问卷中回答被建议在学校筛查后去新潟大学医院就诊的学生被定义为脊柱侧凸组（51 人；0.159%），其余学生被定义为无脊柱侧凸组（32083 人）。比较了两组间的背痛时点患病率、终生患病率、持续时间、复发率、严重程度和位置。背痛的严重程度分为三级（1 级，任何活动均不受限制；2 级，必须避免参加体育和体力活动；3 级，必须缺课）。无脊柱侧凸组的时点患病率为 11.4%，脊柱侧凸组为 27.5%。无脊柱侧凸组的终生患病率为 32.9%，脊柱侧凸组为 58.8%。在校级和性别调整的比值比（OR）分析中，脊柱侧凸组的背痛时点患病率和终生患病率均显著高于无脊柱侧凸组（时点患病率 OR，2.29；P=0.009；终生患病率 OR，2.10；P=0.012）。与无脊柱侧凸组相比，脊柱侧凸组的疼痛更严重，持续时间更长，复发频率更高。与无脊柱侧凸组相比，脊柱侧凸组的上背部和中背部右侧疼痛更为明显。这些发现表明，脊柱侧凸组右侧肩胛周围疼痛与 IS 常见的右侧肋骨隆起之间存在关联。
