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腰椎间盘突出症患者的骶髂关节功能障碍:一项横断面研究。

Sacroiliac joint dysfunction in patients with herniated lumbar disc: a cross-sectional study.

作者信息

Madani Seyed Pezhman, Dadian Mohammad, Firouznia Keykavous, Alalawi Salah

机构信息

Department of Physical Medicine and Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

J Back Musculoskelet Rehabil. 2013;26(3):273-8. doi: 10.3233/BMR-130376.

Abstract

OBJECTIVES

To determine the relative frequency of sacroiliac joint dysfunction in a sample of patients with image proven lumbar disc herniation.

METHODS

A single group cross-sectional study was conducted in a three year period from 2007 in an outpatient clinic at a university hospital. Overall, 202 patients aged more than or equal to 18 years with image proven herniated lumbar disc and with physical findings suggestive of lumbosacral root irritation were included.

RESULTS

Overall, 146 (72.3%) participants had sacroiliac joint dysfunction. The dysfunction was significantly more prevalent in females (p< 0.001, adjusted OR=2.46, 95% CI=1.00 to 6.03), patients with recurrent pain (p< 0.005, adjusted OR=2.33 with 95% CI=1.10 to 4.89) and patients with positive straight leg raising provocative test (p< 0.0001, adjusted OR=5.07, 95% CI=2.37 to 10.85). There was no significant relationship between the prevalence of SIJD, and working hours, duration of low back pain, or body mass index.

CONCLUSIONS

Sacroiliac joint dysfunction is a significant pathogenic factor with high possibility of occurrence in low back pain. Thus, regardless of intervertebral disc pathology, sacroiliac joint dysfunction must be considered in clinical decision making.

摘要

目的

确定经影像学证实为腰椎间盘突出症的患者样本中骶髂关节功能障碍的相对频率。

方法

2007年起在一所大学医院的门诊进行了一项为期三年的单组横断面研究。总共纳入了202例年龄大于或等于18岁、经影像学证实有腰椎间盘突出且有提示腰骶神经根刺激的体格检查结果的患者。

结果

总体而言,146名(72.3%)参与者存在骶髂关节功能障碍。该功能障碍在女性中更为普遍(p<0.001,校正后的OR=2.46,95%CI=1.00至6.03)、复发性疼痛患者中更为普遍(p<0.005,校正后的OR=2.33,95%CI=1.10至4.89)以及直腿抬高激发试验阳性的患者中更为普遍(p<0.0001,校正后的OR=5.07,95%CI=2.37至10.85)。骶髂关节功能障碍的患病率与工作时长、腰痛持续时间或体重指数之间无显著关系。

结论

骶髂关节功能障碍是腰痛发生可能性很高的一个重要致病因素。因此,无论椎间盘病变情况如何,在临床决策中都必须考虑骶髂关节功能障碍。

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