Eguchi Yawara, Suzuki Munetaka, Yamanaka Hajime, Tamai Hiroshi, Kobayashi Tatsuya, Orita Sumihisa, Yamauchi Kazuyo, Suzuki Miyako, Inage Kazuhide, Kanamoto Hirohito, Abe Koki, Aoki Yasuchika, Koda Masao, Furuya Takeo, Takahashi Kazuhisa, Ohtori Seiji
Department of Orthopedic Surgery, National Hospital Organization Shimoshizu National Hospital, Yotsukaido, Japan.
Department of Orthopedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
Korean J Spine. 2017 Mar;14(1):1-6. doi: 10.14245/kjs.2017.14.1.1. Epub 2017 Mar 31.
It is important to develop an easy means of diagnosing lumbar foraminal stenosis (LFS) in a general practice setting. We investigated the use of the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ) to diagnose LFS in symptomatic patients.
Subjects included 13 cases (mean age, 72 years) with LFS, and 30 cases (mean age, 73 years) with lumbar spinal canal stenosis (LSCS) involving one intervertebral disc. The visual analogue scale score for low back pain and leg pain, the JOABPEQ were evaluated.
Those with LFS had a significantly lower JOA score (p<0.001), while JOABPEQ scores (p<0.05) for lumbar dysfunction and social functioning impairment (p<0.01) were both significantly lower than the scores in LSCS. The following JOABPEQ questionnaire items (LFS vs. LSCS, p-value) for difficulties in: sleeping (53.8% vs. 16.6%, p<0.05), getting up from a chair (53.8% vs. 6.6%, p<0.001), turning over (76.9% vs. 40%, p<0.05), and putting on socks (76.9% vs. 26.6%, p<0.01) such as pain during rest, and signs of intermittent claudication more than 15 minutes (61.5% vs. 26.6%, p<0.05) were all significantly more common with LFS than LSCS.
Results suggest that of the items in the JOABPEQ, if pain during rest or intermittent claudication is noted, LFS should be kept in mind as a cause during subsequent diagnosis and treatment. LFS may be easily diagnosed from LSCS using this established patient-based assessment method.
开发一种在普通医疗环境中诊断腰椎管狭窄症（LFS）的简便方法很重要。我们研究了使用日本骨科协会背痛评估问卷（JOABPEQ）来诊断有症状患者的LFS。
研究对象包括13例LFS患者（平均年龄72岁）和30例涉及一个椎间盘的腰椎管狭窄症（LSCS）患者（平均年龄73岁）。评估了下腰痛和腿痛的视觉模拟量表评分以及JOABPEQ。
LFS患者的JOA评分显著更低（p<0.001），而LFS患者的腰椎功能障碍JOABPEQ评分（p<0.05）和社会功能损害评分（p<0.01）均显著低于LSCS患者。JOABPEQ问卷中关于以下困难的项目（LFS与LSCS，p值）：睡眠困难（53.8%对16.6%，p<0.05）、从椅子上起身困难（53.8%对6.6%，p<0.001）、翻身困难（76.9%对40%，p<0.05）以及穿袜子困难（76.9%对26.6%，p<0.01），如休息时疼痛，以及间歇性跛行超过15分钟的体征（61.5%对26.6%，p<0.05），在LFS患者中均比LSCS患者显著更常见。
结果表明，在JOABPEQ的项目中，如果注意到休息时疼痛或间歇性跛行，在后续诊断和治疗过程中应考虑LFS作为病因。使用这种既定的基于患者的评估方法，LFS可能很容易与LSCS区分开来。
