未经治疗的Scheuermann 病：一项 37 年随访研究。
Untreated Scheuermann's disease: a 37-year follow-up study.
机构信息
ORTON Orthopaedic Hospital and ORTON Research Institute, Helsinki, Finland.
出版信息
Eur Spine J. 2012 May;21(5):819-24. doi: 10.1007/s00586-011-2075-0. Epub 2011 Nov 22.
INTRODUCTION
There are only a few follow-up studies of untreated Scheuermann's disease. The aim of this study was to investigate the relationship between vertebral changes, back pain, and disability in patients with untreated Scheuermann's disease after a 37-year follow-up.
MATERIALS AND METHODS
Eighty patients responded to a postal questionnaire concerning back pain and disability and 49 of them had classic Scheuermann's disease. Degree of kyphosis, lordosis, scoliosis, the number of affected vertebrae, and mean and maximum wedge angles were measured from radiographs. Back pain and disability scores were compared to a sample of the general Finnish population (n = 3,835).
RESULTS
At follow-up, the patients were on average 59 (SD 8) years old (range 44-79 years), and the mean follow-up time was 37 (SD 7) years (26-54 years). The patients comprised more males than females (3.1:1). At follow-up, male patients were on average 3 cm taller than controls (p = 0.007). At age 20, female patients compared to controls were on average 6 kg heavier (p = 0.016) and had higher body mass index (BMI) (mean 23.9 kg/m(2) vs. 20.8 kg/m(2), p = 0.001). Scheuermann's patients had 2.5-fold [odds ratio (OR); 95% confidence interval (CI); 1.4-4.5, p = 0.003] increased risk for constant back pain compared to controls. The risk for disability because of back pain during the past 5 years (OR 2.6; 95% CI 1.4-4.7, p = 0.002), risk for back pain during the past 30 days (OR 3.7; 95% CI 1.9-7.0, p < 0.001) and risk for sciatic pain (OR 2.3; 95% CI 1.3-4.3, p = 0.005) were higher compared to controls. Scheuermann's patients had higher risk for difficulties in mounting stairs (OR 5.4; 95% CI 2.8-10.3, p < 0.001) and in carrying a 5 kg load for at least 100 m (OR 7.2; 95% CI 3.9-13.3, p < 0.001).
CONCLUSION
Scheuermann's patients had a higher risk for back pain and disabilities during activities of daily living than controls. However, the degree of thoracic kyphosis among Scheuermann's patients was not related to back pain, quality of life, or general health.
简介
仅有少数关于未经治疗的Scheuermann 病的随访研究。本研究旨在调查未经治疗的Scheuermann 病患者在 37 年随访后的椎体变化、背痛和残疾之间的关系。
材料和方法
80 名患者回复了有关背痛和残疾的问卷调查，其中 49 名患有典型的 Scheuermann 病。从 X 光片上测量了后凸、前凸、侧凸的程度、受累椎体的数量以及平均和最大楔形角。将背痛和残疾评分与芬兰普通人群（n=3835）的样本进行比较。
结果
随访时，患者平均年龄为 59 岁（SD 8 岁）（范围为 44-79 岁），平均随访时间为 37 岁（SD 7 岁）（26-54 岁）。男性患者多于女性（3.1:1）。随访时，男性患者比对照组平均高 3 厘米（p=0.007）。在 20 岁时，女性患者比对照组平均重 6 公斤（p=0.016），体重指数（BMI）更高（平均 23.9 kg/m2 与 20.8 kg/m2，p=0.001）。Scheuermann 患者发生慢性背痛的风险比对照组高 2.5 倍（比值比（OR）；95%置信区间（CI）；1.4-4.5，p=0.003）。在过去 5 年中因背痛而残疾的风险（OR 2.6；95%CI 1.4-4.7，p=0.002）、过去 30 天背痛的风险（OR 3.7；95%CI 1.9-7.0，p<0.001）和坐骨神经痛的风险（OR 2.3；95%CI 1.3-4.3，p=0.005）均高于对照组。Scheuermann 患者在上下楼梯（OR 5.4；95%CI 2.8-10.3，p<0.001）和携带至少 5 公斤重物行走 100 米（OR 7.2；95%CI 3.9-13.3，p<0.001）方面的困难风险更高。
结论
Scheuermann 患者在日常生活活动中的背痛和残疾风险高于对照组。然而，Scheuermann 患者的胸腰椎后凸程度与背痛、生活质量或一般健康状况无关。
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