Spine Center, Seoul National University College of Medicine, Bundang-gu, Sungnam, Republic of Korea.
Spine (Phila Pa 1976). 2013 Jul 15;38(16):E1013-9. doi: 10.1097/BRS.0b013e31828ffa15.
A retrospective case-control analysis of prospectively collected data.
First, to evaluate spinal intervertebral mobility in patients with joint hypermobility (JHM) and matched controls without JHM, and second, to investigate the influence of JHM on back pain, disability, and general health status in young males.
Despite the significance of benign JHM in the musculoskeletal feature, there have been no studies regarding low back pain and segmental motion in subjects with JHM. Furthermore, the clinical significance of the excessive segmental motion in young males with JHM remains unknown.
The JHM group included 32 subjects who had Beighton scale score of 4 or more according to 9° Beighton scale. The age-matched 32 young males without JHM were selectively included in the control group. In both groups, Oswestry Disability Index (ODI), visual analogue pain scale (VAS) for back pain, and Short-Form 36 was assessed. Radiological sagittal plane motions for each segment and whole lumbar spine were calculated as the difference between the Cobb angle measurements in the flexion and extension plain radiographs. In the lateral radiograph with neutral standing position, the intervertebral disc heights were also measured at each segment.
The JHM group showed significantly larger range of motion and higher intervertebral disc height at each matched segment than the control group. The JHM group had significant increased VAS for back pain and ODI score, compared with control group. The Short-Form 36 physical function, role physical, role emotional, and physical component summary in the JHM group were significantly lower than in the control group.
This study shows that young males with JHM were found to have excessive lumbar segmental motion that was associated with increased low back pain, disability, and limited physical activity.
前瞻性收集数据的回顾性病例对照分析。
首先,评估关节过度活动(JHM)患者与无 JHM 的匹配对照者的脊柱椎间活动度,其次,研究 JHM 对年轻男性腰痛、残疾和一般健康状况的影响。
尽管良性 JHM 在肌肉骨骼特征中意义重大,但目前尚无关于 JHM 患者的下腰痛和节段运动的研究。此外,JHM 年轻男性过度节段运动的临床意义尚不清楚。
JHM 组包括 32 名 Beighton 量表评分≥4 分的患者。年龄匹配的 32 名无 JHM 的年轻男性被选择性纳入对照组。在两组中,均评估 Oswestry 残疾指数(ODI)、腰痛视觉模拟评分(VAS)和健康调查简表 36 项(SF-36)。每个节段和整个腰椎矢状面运动通过屈伸位 X 线片 Cobb 角测量值之间的差值计算得出。中立位侧位 X 线片上,还测量每个节段的椎间盘高度。
与对照组相比,JHM 组各匹配节段的运动范围明显更大,椎间盘高度更高。与对照组相比,JHM 组的腰痛 VAS 和 ODI 评分显著增加。JHM 组的 SF-36 生理功能、生理角色、情感角色和生理成分综合评分明显低于对照组。
本研究表明,JHM 年轻男性存在过度的腰椎节段运动,与腰痛增加、残疾和活动受限有关。