Institute of Human Movement Sciences and Sport, ETH Zurich, Wolfgang Pauli Str, 27, 8093 Zurich, Switzerland.
BMC Pediatr. 2013 Oct 5;13:159. doi: 10.1186/1471-2431-13-159.
The key to a better understanding of the immense problem of spinal pain seems to be to investigate its development in adolescents. Based on the data of Spine Day 2012 (an annual action day where Swiss school children were examined by chiropractors on a voluntary basis for back problems), the aim of the present study was to gain systematic epidemiologic data on adolescent spinal pain in Switzerland and to explore risk factors per gender and per spinal area.
Data (questionnaires and physical examinations) of 836 school children were descriptively analyzed for prevalence, recurrence and severity of spinal pain. Of those, 434 data sets were included in risk factor analysis. Using logistic regression analysis, psycho-social parameters (presence of parental back pain, parental smoking, media consumption, type of school bag) and physical parameters (trunk symmetry, posture, mobility, coordination, BMI) were analyzed per gender and per spinal area.
Prevalence of spinal pain was higher for female gender in all areas apart from the neck. With age, a steep increase in prevalence was observed for low back pain (LBP) and for multiple pain sites. The increasing impact of spinal pain on quality of life with age was reflected in an increase in recurrence, but not in severity of spinal pain. Besides age and gender, parental back pain (Odds ratio (OR)=3.26, p=0.011) and trunk asymmetry (OR=3.36, p=0.027) emerged as risk factors for spinal pain in girls. Parental smoking seemed to increase the risk for both genders (boys: OR=2.39, p=0.020; girls: OR=2.19, p=0.051). Risk factor analysis per spinal area resulted in trunk asymmetry as risk factor for LBP (OR=3.15, p=0.015), while parental smoking increased the risk for thoracic spinal pain (TSP) (OR=2.83, p=0.036) and neck pain (OR=2.23, p=0.038). The risk for TSP was further enhanced by a higher BMI (OR=1.15, p=0.027).
This study supports the view of adolescent spinal pain as a bio-psycho-social problem that should be investigated per spinal area, age and gender. The role of trunk asymmetry and passive smoking as risk factors as well as the association between BMI and TSP should be further investigated, preferably in prospective studies.
深入了解庞大的脊柱疼痛问题的关键似乎在于研究青少年脊柱疼痛的发展。基于 2012 年脊柱日（瑞士学校儿童自愿接受脊医检查背部问题的年度行动日）的数据，本研究旨在获得瑞士青少年脊柱疼痛的系统流行病学数据，并探讨按性别和脊柱区域划分的危险因素。
对 836 名学生的问卷调查和体格检查数据进行描述性分析，以了解脊柱疼痛的患病率、复发率和严重程度。其中，434 份数据被纳入危险因素分析。使用逻辑回归分析，按性别和脊柱区域分析心理社会参数（父母背痛、父母吸烟、媒体消费、书包类型）和身体参数（躯干对称性、姿势、活动度、协调性、BMI）。
除颈部外，所有区域女性的脊柱疼痛患病率均高于男性。随着年龄的增长，腰痛（LBP）和多个疼痛部位的患病率急剧上升。脊柱疼痛对生活质量的影响随年龄的增长而增加，这反映在复发率的增加，但疼痛严重程度没有增加。除年龄和性别外，父母背痛（比值比（OR）=3.26，p=0.011）和躯干不对称（OR=3.36，p=0.027）是女孩脊柱疼痛的危险因素。父母吸烟似乎增加了两种性别的风险（男孩：OR=2.39，p=0.020；女孩：OR=2.19，p=0.051）。按脊柱区域进行危险因素分析，结果显示躯干不对称是 LBP 的危险因素（OR=3.15，p=0.015），而父母吸烟增加了 TSP（OR=2.83，p=0.036）和颈痛（OR=2.23，p=0.038）的风险。BMI 较高（OR=1.15，p=0.027）进一步增加了 TSP 的风险。
本研究支持青少年脊柱疼痛是一个生物心理社会问题的观点，应按脊柱区域、年龄和性别进行研究。应进一步研究躯干不对称和被动吸烟作为危险因素的作用，以及 BMI 与 TSP 之间的关联，最好在前瞻性研究中进行。
