Lee Sun-Mi, Oh Su Chan, Yeom Jin S, Shin Ji-Hoon, Park Sam-Guk, Shin Duk-Seop, Ahn Myun-Whan, Lee Gun Woo
Department of Family Medicine, Dongkang Hospital, 239, Taehwa-ro, Jung-gu, Ulsan 44455, Korea.
Spine Center and Department of Orthopaedic Surgery, Seoul National University College of Medicine and Seoul National University Bundang Hospital, 82, Gumi-ro 173beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do 13620, Korea.
Spine J. 2016 Dec;16(12):1453-1458. doi: 10.1016/j.spinee.2016.08.009. Epub 2016 Aug 5.
Generalized joint laxity (GJL) can have a negative impact on lumbar spine pathology, including low back pain, disc degeneration, and disc herniation, but the relationship between GJL and cervical spine conditions remains unknown.
To investigate the relationship between GJL and cervical spine conditions, including the prevalence of posterior neck pain (PNP), cervical disc herniation (CDH), and cervical disc degeneration (CDD), in a young, active population.
Retrospective 1:2 matched cohort (case-control) study from prospectively collected data PATIENT SAMPLE: Of a total of 1853 individuals reviewed, 73 individuals with GJL (study group, gruop A) and 146 without GJL (control group, Group B) were included in the study according to a 1:2 case-control matched design for age, sex, and body mass index.
The primary outcome measure was the prevalence and intensity of PNP at enrollment based on a visual analogue scale score for pain. The secondary outcome measures were (1) clinical outcomes as measured with the neck disability index (NDI) and 12-item short form health survey (SF-12) at enrollment, and (2) radiological outcomes of CDH and CDD at enrollment.
We compared baseline data between groups. Descriptive statistical analyses were performed to compare the 2 groups in terms of the outcome measures.
The prevalence and intensity of PNP were significantly greater in group A (patients with GJL) than in group B (patients without GJL) (prevalence: p=.02; intensity: p=.001). Clinical outcomes as measured with NDI and SF-12 did not differ significantly between groups. For radiologic outcomes, the prevalence of CDD was significantly greater in group A than in group B (p=.04), whereas the prevalence of CDH did not differ significantly between groups (p=.91).
The current study revealed that GJL was closely related to the prevalence and intensity of PNP, suggesting that GJL may be a causative factor for PNP. In addition, GJL may contribute to the occurrence of CDD, but not CDH. Spine surgeons should screen for GJL in patientswith PNP and inform patients of its potential negative impact on disc degeneration of the cervical spine.
全身关节松弛（GJL）会对腰椎病理状况产生负面影响，包括下腰痛、椎间盘退变和椎间盘突出，但GJL与颈椎疾病之间的关系尚不清楚。
在年轻、活跃的人群中研究GJL与颈椎疾病之间的关系，包括颈后部疼痛（PNP）、颈椎间盘突出（CDH）和颈椎间盘退变（CDD）的患病率。
对前瞻性收集的数据进行回顾性1:2匹配队列（病例对照）研究
在总共1853名接受评估的个体中，根据年龄、性别和体重指数的1:2病例对照匹配设计，73名GJL患者（研究组，A组）和146名无GJL患者（对照组，B组）被纳入研究。
主要观察指标是入组时基于疼痛视觉模拟量表评分的PNP患病率和强度。次要观察指标为：（1）入组时用颈部功能障碍指数（NDI）和12项简短健康调查问卷（SF-12）测量的临床结局；（2）入组时CDH和CDD的影像学结局。
我们比较了两组之间的基线数据。进行描述性统计分析以比较两组的观察指标。
A组（GJL患者）的PNP患病率和强度显著高于B组（无GJL患者）（患病率：p = 0.02；强度：p = 0.001）。两组间用NDI和SF-12测量的临床结局无显著差异。对于影像学结局，A组的CDD患病率显著高于B组（p = 0.04），而两组间的CDH患病率无显著差异（p = 0.91）。
本研究表明，GJL与PNP的患病率和强度密切相关，提示GJL可能是PNP的一个致病因素。此外，GJL可能促成CDD的发生，但与CDH无关。脊柱外科医生应对PNP患者筛查GJL，并告知患者其对颈椎间盘退变的潜在负面影响。
