特发性脊柱侧凸青少年的背痛患病率与脊柱侧凸类型及严重程度相关：一项横断面研究
Back Pain Prevalence Is Associated With Curve-type and Severity in Adolescents With Idiopathic Scoliosis: A Cross-sectional Study.
作者信息
Théroux Jean, Le May Sylvie, Hebert Jeffrey J, Labelle Hubert
机构信息
Research Center, Sainte-Justine University Hospital Center, Montreal, Quebec, Canada.
School of Health Profession, Murdoch University, Murdoch, Western Australia, Australia.
出版信息
Spine (Phila Pa 1976). 2017 Aug 1;42(15):E914-E919. doi: 10.1097/BRS.0000000000001986.
STUDY DESIGN
A cross-sectional study.
OBJECTIVES
The aim of this study was to investigate spinal pain prevalence in adolescents with idiopathic scoliosis (AIS) and to explore associations between pain intensity and pain-related disability with scoliosis site, severity, and spinal bracing.
SUMMARY OF BACKGROUND DATA
The causal link between spinal pain and AIS remains unclear. Spinal asymmetry has been recognized as a back pain risk factor, which is a known cause of care-seeking in adolescents.
METHODS
Participants were recruited from an outpatient tertiary-care scoliosis clinic. Pain intensity and pain-related disability were measured by the Brief Pain Inventory questionnaire and the Roland-Morris Disability Questionnaire. Scoliosis severity estimation was performed using Cobb angles. Associations were explored using multiple linear regressions and reported with unstandardized beta coefficients (β) adjusted for age and sex.
RESULTS
We recruited 500 patients (85% female) with mean (SD) age of 14.2 (1.8) years. Means (SD) of thoracic and lumbar Cobb angle were 24.54(9.77) and 24.13 (12.40), respectively. Spinal pain prevalence was 68% [95% confidence interval (95% CI): 64.5-72.4] with a mean intensity of 1.63 (SD, 1.89). Spinal pain intensity was positively associated with scoliosis severity in the main thoracic (P = 0.003) and lumbar (P = 0.001) regions. The mean (SD) disability score was 1.73 (2.98). Disability was positively associated with scoliosis severity in the proximal thoracic (P = 0.035), main thoracic (P = 0.000), and lumbar (P = 0.000) regions.Spinal bracing was associated with lower spinal pain intensity in the thoracic (P = 0.000) and lumbar regions (P = 0.009). Bracing was also related with lower disability for all spinal areas (P < 0.045).
CONCLUSION
Spinal pain is common among patients with AIS, and greater spinal deformity was associated with higher pain intensity. These findings should inform clinical decision-making when caring for patients with AIS.
LEVEL OF EVIDENCE
研究设计
横断面研究。
目的
本研究旨在调查特发性脊柱侧凸（AIS）青少年的脊柱疼痛患病率，并探讨疼痛强度和疼痛相关残疾与脊柱侧凸部位、严重程度及脊柱支具之间的关联。
背景数据总结
脊柱疼痛与AIS之间的因果关系仍不清楚。脊柱不对称已被认为是背痛的危险因素，这是青少年寻求治疗的一个已知原因。
方法
参与者从一家三级门诊脊柱侧凸诊所招募。疼痛强度和疼痛相关残疾通过简明疼痛量表问卷和罗兰·莫里斯残疾问卷进行测量。使用Cobb角进行脊柱侧凸严重程度评估。使用多元线性回归探索关联，并报告经年龄和性别调整的非标准化β系数（β）。
结果
我们招募了500名患者（85%为女性），平均（标准差）年龄为14.2（1.8）岁。胸段和腰段Cobb角的平均值（标准差）分别为24.54（9.77）和24.13（12.40）。脊柱疼痛患病率为68%[95%置信区间（95%CI）：64.5 - 72.4]，平均强度为1.63（标准差，1.89）。脊柱疼痛强度与胸主段（P = 0.003）和腰段（P = 0.001）的脊柱侧凸严重程度呈正相关。平均（标准差）残疾评分为1.73（2.98）。残疾与近端胸段（P = 0.035）、胸主段（P = 0.000）和腰段（P = 0.000）的脊柱侧凸严重程度呈正相关。脊柱支具与胸段（P = 0.000）和腰段（P = 0.009）较低的脊柱疼痛强度相关。支具也与所有脊柱区域较低的残疾相关（P < 0.045）。
结论
脊柱疼痛在AIS患者中很常见，脊柱畸形越严重，疼痛强度越高。这些发现应为AIS患者的临床护理决策提供参考。
证据水平
3级。
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