Research Department, The Spine Centre of Southern Denmark, Hospital Lillebaelt, Institute of Regional Health Services Research, University of Southern Denmark, Clinical Locomotion Science Network, Middelfart, Denmark.
BMC Musculoskelet Disord. 2012 Nov 28;13:236. doi: 10.1186/1471-2474-13-236.
Leg pain associated with low back pain (LBP) is recognized as a risk factor for a poor prognosis, and is included as a component in most LBP classification systems. The location of leg pain relative to the knee and the presence of a positive straight leg raise test have been suggested to have clinical implications. To understand differences between such leg pain subgroups, and whether differences include potentially modifiable characteristics, the purpose of this paper was to describe characteristics of patients classified into the Quebec Task Force (QTF) subgroups of: 1) LBP only, 2) LBP and pain above the knee, 3) LBP and pain below the knee, and 4) LBP and signs of nerve root involvement.
Analysis of routine clinical data from an outpatient department. Based on patient reported data and clinical findings, patients were allocated to the QTF subgroups and described according to the domains of pain, activity limitation, work participation, psychology, general health and clinical examination findings.
A total of 2,673 patients aged 18-95 years (median 47) who were referred for assessment of LBP were included. Increasing severity was consistently observed across the subgroups from LBP only to LBP with signs of nerve root involvement although subgroup differences were small. LBP patients with leg pain differed from those with LBP only on a wide variety of parameters, and patients with signs of nerve root involvement had a more severe profile on almost all measures compared with other patients with back-related leg pain.
LBP patients with pain referral to the legs were more severely affected than those with local LBP, and patients with signs of nerve root involvement were the ones most severily affected. These findings underpin the concurrent validity of the Quebec Task Force Classification. However, the small size of many between-subgroup differences amid the large variability in this sample of cross-sectional data also underlines that the heterogeneity of patients with LBP is more complex than that which can be explained by leg pain patterns alone. The implications of the observed differences also require investigation in longitudinal studies.
与下腰痛（LBP）相关的腿痛被认为是预后不良的一个危险因素，并被纳入大多数 LBP 分类系统的组成部分。腿痛相对于膝关节的位置和直腿抬高试验阳性已被认为具有临床意义。为了了解这些腿痛亚组之间的差异，以及这些差异是否包括潜在的可改变的特征，本文的目的是描述根据魁北克任务组（QTF）亚组分类的患者的特征：1）仅 LBP，2）LBP 和膝关节以上疼痛，3）LBP 和膝关节以下疼痛，以及 4）LBP 和神经根受累迹象。
对门诊患者的常规临床数据进行分析。根据患者报告的数据和临床发现，将患者分配到 QTF 亚组，并根据疼痛、活动受限、工作参与、心理、一般健康和临床检查结果等领域进行描述。
共纳入 2673 名 18-95 岁（中位数 47）岁的患者，因评估下腰痛而就诊。尽管亚组间差异较小，但从仅有 LBP 到有神经根受累迹象的 LBP，严重程度呈逐渐增加趋势。有腿痛的 LBP 患者与仅有 LBP 的患者在各种参数上存在差异，有神经根受累迹象的患者在几乎所有测量指标上的病情都比其他与背部相关的腿痛患者更为严重。
有腿部疼痛的 LBP 患者比仅有局部 LBP 的患者病情更为严重，而有神经根受累迹象的患者则是受影响最严重的患者。这些发现支持了魁北克任务组分类的同时效度。然而，在横断面数据的大变异中，许多亚组间差异的规模较小，也强调了 LBP 患者的异质性比仅通过腿部疼痛模式所能解释的更为复杂。观察到的差异的意义也需要在纵向研究中进行调查。
