Shortz Savannah K, Haas Mitchell
Department of Undergraduate and Graduate Studies, University of Western States, Portland, Oregon.
Earl E. Bakken Center for Spirituality and Healing, University of Minnesota, Minneapolis, Minnesota.
J Chiropr Med. 2018 Mar;17(1):1-6. doi: 10.1016/j.jcm.2017.10.005. Epub 2018 Jan 17.
The purpose of this study was to investigate correlative factors affecting chronic low back pain (CLBP), with special emphasis on the radiographic postural findings in the sagittal lumbosacral spine.
A cross-sectional study alongside a randomized trial was conducted. Standing lateral lumbar spine radiographs from 352 patients with CLBP enrolled in a randomized trial were analyzed and radiographic mensuration of lumbar lordosis, lumbosacral disc angle, and sacral inclination performed. These angles were correlated with baseline variables, including CLBP intensity, age, and sex. Multiple polynomial regressions were performed in which CLBP intensity was regressed on linear and quadratic terms of lumbar lordosis to investigate the possibility of greater pain with hypo- and/or hyperlordosis.
There was no significant correlation of the angles with pain and age ( ≤ 0.09, > .05). Weak but statistically significant correlation was identified between all 3 measurements and sex ( = -0.12 to 0.21, < .05). Greater pain was not noted for hypo- and hyperlordosis; regression coefficients for the linear and quadratic effects were approximately 0 ( > .05).
This study determined that there was no correlation between lumbar lordosis and pain levels for people with CLBP; thus, use of lumbar spine radiographic mensuration in the management of pain for people with CLBP is not recommended.
本研究旨在调查影响慢性下腰痛(CLBP)的相关因素,特别关注腰骶部矢状位的影像学姿势表现。
开展了一项横断面研究及一项随机试验。对纳入一项随机试验的352例CLBP患者的站立位腰椎侧位X线片进行分析,并对腰椎前凸、腰骶椎间盘角度和骶骨倾斜度进行影像学测量。将这些角度与包括CLBP强度、年龄和性别在内的基线变量进行关联分析。进行了多项多项式回归分析,将CLBP强度与腰椎前凸的线性和二次项进行回归,以研究腰椎前凸减小和/或增大时疼痛加剧的可能性。
这些角度与疼痛和年龄无显著相关性(≤0.09,P>.05)。在所有3项测量值与性别之间发现了微弱但具有统计学意义的相关性(r=-0.12至0.21,P<.05)。腰椎前凸减小和增大时均未发现疼痛加剧;线性和二次效应的回归系数约为0(P>.05)。
本研究确定CLBP患者的腰椎前凸与疼痛程度之间无相关性;因此,不建议在CLBP患者的疼痛管理中使用腰椎X线测量。