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全身关节松弛与腰椎间盘突出症的初次发病及治疗结果相关。

Generalized Joint Laxity is Associated with Primary Occurrence and Treatment Outcome of Lumbar Disc Herniation.

作者信息

Han Woo Jin, Kim Hong-Bae, Lee Gun Woo, Choi Jung Heum, Jo Won Jin, Lee Sun-Mi

机构信息

Department of Family Medicine, Myongji Hospital, Goyang, Korea.

Department of Orthopaedic Surgery, Armed Forces Yangju Hospital, Yangju, Korea.

出版信息

Korean J Fam Med. 2015 May;36(3):141-5. doi: 10.4082/kjfm.2015.36.3.141. Epub 2015 May 22.

Abstract

BACKGROUND

We investigated relationships between generalized joint laxity and primary lumbar disc herniation occurrence and compared clinical outcomes after conservative treatment in lumbar disc herniation patients with and without generalized joint laxity.

METHODS

The study group included 128 men, and the control group included 276 men matched for age and body mass index with the study group. The primary outcome measure was the presence or absence of generalized joint laxity using the Beighton scale. Clinical outcomes measured by the visual analog scale and the Oswestry disability index 2 years after conservative treatment were the secondary outcome measure.

RESULTS

Generalized joint laxity prevalence was 13.2% in the study group and 5.1% in the control group, a significant difference (P=0.01). Spearman correlation analysis revealed that weight (r=0.162, P=0.03), body mass index (r=0.131, P=0.03), and generalized joint laxity (r=0.372, P<0.01) significantly correlated with lumbar disc herniation occurrence. In multivariate regression analysis, generalized joint laxity was the only significant lumbar disc herniation predictor (P=0.002; 95% confidence interval, 1.08 to 5.26). Generalized joint laxity in lumbar disc herniation patients was associated with worse clinical outcomes after conservative treatment measured by visual analog scale scores for lower extremity pain (P=0.02), lower back pain (P=0.03), and Oswestry disability index scores (P=0.03).

CONCLUSION

Generalized joint laxity might be associated with lumbar disc herniation occurrence and might also be a negative predictor of worse clinical outcomes after conservative treatment.

摘要

背景

我们研究了全身关节松弛与原发性腰椎间盘突出症发生之间的关系,并比较了有和没有全身关节松弛的腰椎间盘突出症患者保守治疗后的临床结果。

方法

研究组包括128名男性,对照组包括276名年龄和体重指数与研究组相匹配的男性。主要结局指标是使用Beighton量表评估是否存在全身关节松弛。保守治疗2年后通过视觉模拟量表和Oswestry功能障碍指数测量的临床结果是次要结局指标。

结果

研究组全身关节松弛患病率为13.2%,对照组为5.1%,差异有统计学意义(P=0.01)。Spearman相关性分析显示,体重(r=0.162,P=0.03)、体重指数(r=0.131,P=0.03)和全身关节松弛(r=0.372,P<0.01)与腰椎间盘突出症的发生显著相关。在多因素回归分析中,全身关节松弛是唯一显著的腰椎间盘突出症预测因素(P=0.002;95%置信区间,1.08至5.26)。腰椎间盘突出症患者的全身关节松弛与保守治疗后较差的临床结果相关,通过视觉模拟量表评估下肢疼痛(P=0.02)、下背部疼痛(P=0.03)和Oswestry功能障碍指数评分(P=0.03)。

结论

全身关节松弛可能与腰椎间盘突出症的发生有关,也可能是保守治疗后临床结果较差的负面预测因素。

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