Kang Eun Kyoung, Park Hee-Won, Kim Sung Hyun, Baek Sora
Center for Farmers' Safety and Health and Department of Rehabilitation Medicine, Kangwon National University Hospital, Chuncheon, Korea.
Gangwon-Do Rehabilitation Hospital, Chuncheon, Korea.
Ann Rehabil Med. 2017 Oct;41(5):808-815. doi: 10.5535/arm.2017.41.5.808. Epub 2017 Oct 31.
To elucidate the association between non-specific low back pain (NSLBP) and spinal X-ray findings in Korean farmers: Farmers' Cohort for Agricultural Work-Related Musculoskeletal disorders (FARM) study.
A total of 835 farmers (391 males, 444 females; mean age, 56.6±7.4 years) without red-flag signs of specific LBP were recruited. Presence of LBP more than one week or once a month with more than moderate degree of pain severity during the last year was assessed with a binary questionnaire (yes or no). Spinal degenerative changes were classified into disc height change (DHC) of L4-5 and L5-S1 (grade 0-5) and osteophyte formation of L5 (grade 0-5) by a radiologist based on X-ray findings. Additionally, spondylolisthesis, scoliosis and spondylolysis were assessed.
General prevalence of NSLBP was 40.7%, revealing a higher incidence of NSLBP in female and younger farmers compared to male and older farmers (χ=23.3, p<0.001; χ=4.54, p<05, respectively). Among X-ray findings, DHC (L5-S1) grade 4 revealed significantly higher relative risk of NSLBP compared to grade 0 (odds ratio, 5.00; 95% confidence interval, 2.05-12.20) after adjusting age and sex, while other X-ray findings were not associated with NSLBP.
The NSLBP of Korean farmers was significantly related to lumbar disc degenerative changes, suggesting clinical usefulness of X-ray findings in assessing LBP in farmers.
阐明韩国农民非特异性下腰痛(NSLBP)与脊柱X线检查结果之间的关联:农业工作相关肌肉骨骼疾病农民队列(FARM)研究。
招募了835名无特异性腰痛红旗体征的农民(391名男性,444名女性;平均年龄56.6±7.4岁)。通过二元问卷(是或否)评估过去一年中是否存在持续一周以上或每月一次以上且疼痛严重程度超过中度的腰痛。放射科医生根据X线检查结果将脊柱退行性改变分为L4-5和L5-S1椎间盘高度变化(DHC,0-5级)以及L5椎体骨赘形成(0-5级)。此外,还评估了椎体滑脱、脊柱侧弯和椎弓峡部裂。
NSLBP的总体患病率为40.7%,女性和年轻农民的NSLBP发病率高于男性和老年农民(χ=23.3,p<0.001;χ=4.54,p<0.05)。在X线检查结果中,调整年龄和性别后,L5-S1的DHC 4级与NSLBP的相对风险显著高于0级(比值比,5.00;95%置信区间,2.05-12.20),而其他X线检查结果与NSLBP无关。
韩国农民的NSLBP与腰椎间盘退变显著相关,提示X线检查结果在评估农民腰痛方面具有临床实用性。