骶髂关节紊乱与腰椎间盘退变相关性的流行病学调查及生物力学分析

[Epidemiology investigation and biomechanics analyses for the correlation between sacroiliac joint disorder and lumbar intervertebral disc degeneration].

作者信息

Shi Ning-Ning, Shen Guo-Quan, He Shui-Yong, Guo Ru-Bao

出版信息

Zhongguo Gu Shang. 2014 Jul;27(7):560-4.

Abstract

OBJECTIVE

To study the correlation between lumber disc degeneration and sacroiliac joint disorder, in order to provides a new understanding concepts and therapeutic approach for the prevention and treatment of chronic intractable low back pain.

METHODS

From August 2009 to October 2010,129 cases with lumbar disc herniation were studied with epidemiological methods. Among them, 61 patients with L4, disc herniation included 37 males and 24 females, ranging in aged from 20 to 75 years old, duration of the disease ranged from 1 to 144 months; The other 68 patients with L5S1 disc herniation included 32 males and 36 females,ranging in aged froml8 to 76 years old,duration of the disease ranged from 0.5 to 240 months. The clinical data, symptoms and signs,X-ray characteristics of lumbar spine and pelvis of the patients were investigated by epidemiological. The risk of lumbar disc herniation was calculated with case-control study; independent variables were screened with single factor analysis; the risk factors for lumbar disc herniation were determined with logistic regression analysis, and biomechanics analyses were taken.

RESULTS

Among 129 patients with lumbar disc herniation, 88 cases associated with sacroiliac joint disorders, sacroiliac joint disorder was a risk factor of lumbar disc herniation (OR = 4.61, P = 0.00); 47 cases associated with sacroiliac joint disorders in 61 patients with L4,5 disc herniation, iliac crest uneven caused by iliac rotational displacement was a high risk factor of L4,5 disc herniation (OR = 11.27, P = 0.00); 41 cases associated with sacroiliac joint disorders in 68 patients with L5S1 disc herniation, lumbar sacral angle abnormalities caused by sacral tilt shift was a high risk factor L5S1 disc herniation (OR = 2.31, P = 0.03).

CONCLUSION

Lumbar disc herniation and sacroiliac joint disorder are two of fallot, the two factors affect each other and there is a causal relationship. They are common exists in low back pain.

摘要

目的

研究腰椎间盘退变与骶髂关节紊乱之间的相关性，为慢性顽固性下腰痛的防治提供新的认识理念和治疗方法。

方法

2009年8月至2010年10月，采用流行病学方法对129例腰椎间盘突出症患者进行研究。其中，61例L4、5椎间盘突出症患者，男37例，女24例，年龄20～75岁，病程1～144个月；另68例L5S1椎间盘突出症患者，男32例，女36例，年龄18～76岁，病程0.5～240个月。采用流行病学方法调查患者的临床资料、症状体征、腰椎及骨盆X线特征。采用病例对照研究计算腰椎间盘突出症的发病风险；采用单因素分析筛选自变量；采用logistic回归分析确定腰椎间盘突出症的危险因素，并进行生物力学分析。

结果

129例腰椎间盘突出症患者中，88例合并骶髂关节紊乱，骶髂关节紊乱是腰椎间盘突出症的危险因素（OR=4.61，P=0.00）；61例L4、5椎间盘突出症患者中47例合并骶髂关节紊乱，髂骨旋转移位致髂嵴不平是L4、5椎间盘突出症的高危因素（OR=11.27，P=0.00）；68例L5S1椎间盘突出症患者中41例合并骶髂关节紊乱，骶骨倾斜移位致腰骶角异常是L5S1椎间盘突出症的高危因素（OR=2.31，P=0.03）。