基于人群队列的腰椎滑脱与腰痛及症状性腰椎管狭窄的关联：和歌山县脊柱研究
Association of Lumbar Spondylolisthesis With Low Back Pain and Symptomatic Lumbar Spinal Stenosis in a Population-based Cohort: The Wakayama Spine Study.
作者信息
Ishimoto Yuyu, Yoshimura Noriko, Muraki Shigeyuki, Yamada Hiroshi, Nagata Keiji, Hashizume Hiroshi, Takiguchi Noboru, Minamide Akihito, Oka Hiroyuki, Tanaka Sakae, Kawaguchi Hiroshi, Nakamura Kozo, Akune Toru, Yoshida Munehito
机构信息
Wakayama Medical University, Wakayama, Japan.
Department of Joint Disease Research, 22nd Century Medical and Research Center, University of Tokyo, Tokyo, Japan.
出版信息
Spine (Phila Pa 1976). 2017 Jun 1;42(11):E666-E671. doi: 10.1097/BRS.0000000000001960.
STUDY DESIGN
Cross-sectional study.
OBJECTIVE
To determine the association between lumbar spondylolisthesis and low back pain and symptomatic lumbar spinal stenosis (LSS) in a population-based cohort.
SUMMARY OF BACKGROUND DATA
The basic epidemiology of lumbar spondylolisthesis is not well known. There is little information regarding the association between lumbar spondylolisthesis and clinical symptoms such as low back pain and LSS symptoms.
METHODS
This cross-sectional study included data from 938 participants (308 males, 630 females; mean age, 67.3 years; range, 40-93 years). Lumbar spondylolisthesis was defined as a slip of ≥5%. Diagnostic criteria for symptomatic LSS required the presence of both leg symptoms and radiographic LSS findings on magnetic resonance imaging. The prevalence of low back pain and symptomatic LSS was compared between those with or without spondylolisthesis. Furthermore, we determined the association between the amount of slippage and presence of symptomatic LSS.
RESULTS
The prevalence of spondylolisthesis at any level was 15.8% in the total sample, 13.0% in males, and 17.1% in females; the prevalence was not significantly different between males and females (P = 0.09). In both, males and females, symptomatic LSS was related to spondylolisthesis [odds ratio (OR): 2.07; 95% CI: 1.20-3.44]; however, no such association was found for spondylolisthesis and presence of low back pain. The amount of slippage was not related to the presence of symptomatic LSS (P = 0.93).
CONCLUSION
This population-based cohort study revealed that lumbar spondylolisthesis had a closer association with leg symptoms than with low back pain. There was a significant difference in the presence of symptomatic LSS between participants with and without spondylolisthesis. However, the amount of slippage was not related to the presence of symptomatic LSS.
LEVEL OF EVIDENCE
研究设计
横断面研究。
目的
确定在一个基于人群的队列中腰椎滑脱与腰痛及症状性腰椎管狭窄（LSS）之间的关联。
背景数据总结
腰椎滑脱的基本流行病学情况尚不为人熟知。关于腰椎滑脱与诸如腰痛和LSS症状等临床症状之间的关联信息很少。
方法
这项横断面研究纳入了938名参与者的数据（男性308名，女性630名；平均年龄67.3岁；范围40 - 93岁）。腰椎滑脱定义为滑移≥5%。症状性LSS的诊断标准要求在磁共振成像上同时存在腿部症状和影像学LSS表现。比较有或无腰椎滑脱者中腰痛和症状性LSS的患病率。此外，我们确定了滑移量与症状性LSS存在之间的关联。
结果
在总样本中，任何节段腰椎滑脱的患病率为15.8%，男性为13.0%，女性为17.1%；男性和女性之间患病率无显著差异（P = 0.09）。在男性和女性中，症状性LSS均与腰椎滑脱相关[比值比（OR）：2.07；95%置信区间（CI）：1.20 - 3.44]；然而，未发现腰椎滑脱与腰痛存在之间有此类关联。滑移量与症状性LSS的存在无关（P = 0.93）。
结论
这项基于人群的队列研究表明，腰椎滑脱与腿部症状的关联比与腰痛的关联更密切。有和无腰椎滑脱的参与者在症状性LSS的存在方面存在显著差异。然而，滑移量与症状性LSS的存在无关。
证据级别
3级
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