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症状性退行性腰椎侧凸的流行病学及相关影像学脊柱骨盆参数:影像学脊柱骨盆参数与退行性腰椎侧凸的症状存在或生活质量下降有关吗?

Epidemiology and associated radiographic spinopelvic parameters of symptomatic degenerative lumbar scoliosis: are radiographic spinopelvic parameters associated with the presence of symptoms or decreased quality of life in degenerative lumbar scoliosis?

作者信息

Iizuka Yoichi, Iizuka Haku, Mieda Tokue, Tajika Tsuyoshi, Yamamoto Atsushi, Takagishi Kenji

机构信息

Department of Orthopedic Surgery, Gunma University Graduate School of Medicine, 3-39-22, Showa, Maebashi, Gunma, 371-8511, Japan.

出版信息

Eur Spine J. 2016 Aug;25(8):2514-9. doi: 10.1007/s00586-015-4256-8. Epub 2015 Sep 30.

Abstract

OBJECTIVES

To investigate the epidemiology of radiographic degenerative lumbar scoliosis (DLS) and symptomatic DLS and clarify the impact of radiographic spinopelvic parameters on the presence of symptoms and quality of life (QOL) in DLS subjects.

METHODS

We obtained the age, gender, screening for chronic low back pain (CLBP) and lumbar spinal stenosis (LSS), QOL assessments and X-rays of the thoracolumbar spine from 254 patients from the general population for this study. The prevalence of DLS and symptomatic DLS were estimated and factors associated with symptoms, and the QOL in the DLS subjects was analysed.

RESULTS

The prevalence of radiographic and symptomatic DLS was 19.2 and 7.8 %, respectively. A female gender (p = 0.018) and decreased sacral slope (p = 0.025) were associated with the presence of CLBP in the DLS subjects. A higher age was also associated with the presence of LSS in these subjects (p = 0.007), whereas the Cobb angle was found to be close the limit for significance (p = 0.063). The sacro-femoral-pubic angle and Cobb angle correlated with the EuroQol-5 dimensions utility score (r = 0.314, p = 0.014) and EuroQol-visual analogue scale score (r = -0.291, p = 0.043), respectively. Lumbar lordosis and body mass index correlated with the lumbar function (r = 0.285, p = 0.047) and visual analogue scale for leg pain (r = 0.328, p = 0.022) on the Japanese Orthopaedic Association Back Pain Questionnaire, respectively.

CONCLUSIONS

The prevalence of radiographic DLS in this study was approximately 20 % and roughly 40 % of the DLS subjects had symptoms. Some spinopelvic parameters may impact the occurrence of symptoms and the QOL in DLS subjects.

摘要

目的

研究影像学退行性腰椎侧凸(DLS)及症状性DLS的流行病学特征,并阐明影像学脊柱骨盆参数对DLS患者症状出现情况及生活质量(QOL)的影响。

方法

本研究从普通人群的254例患者中获取年龄、性别、慢性下腰痛(CLBP)及腰椎管狭窄(LSS)筛查情况、生活质量评估结果以及胸腰椎X线片。估计DLS及症状性DLS的患病率,分析与症状相关的因素以及DLS患者的生活质量。

结果

影像学DLS和症状性DLS的患病率分别为19.2%和7.8%。女性(p = 0.018)和骶骨斜率降低(p = 0.025)与DLS患者CLBP的存在相关。较高年龄也与这些患者LSS的存在相关(p = 0.007),而Cobb角接近显著性临界值(p = 0.063)。骶股耻骨角和Cobb角分别与欧洲五维健康量表效用评分(r = 0.314,p = 0.014)和欧洲五维健康量表视觉模拟量表评分(r = -0.291,p = 0.043)相关。腰椎前凸和体重指数分别与日本骨科协会背痛问卷中的腰椎功能(r = 0.285,p = 0.04)和腿痛视觉模拟量表(r = 0.328,p = 0.022)相关。

结论

本研究中影像学DLS的患病率约为20%,约40%的DLS患者有症状。一些脊柱骨盆参数可能影响DLS患者症状的发生及生活质量。

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