Kemmochi Masahiko, Sasaki Shigeru, Ichimura Shoichi
Kenmochi Orthopedic Surgery Sports Clinic, KOSSMOS Medical Corporation, 42-1 Higashi-honcho Ota City, Gunma, 373-0026, Japan.
Department of Orthopaedic Surgery, Kyorin University, 5-4-1 Mitaka, Shimorenjaku, 181-8612, Tokyo, Japan.
J Orthop. 2018 Jan 16;15(1):122-127. doi: 10.1016/j.jor.2018.01.014. eCollection 2018 Mar.
We noticed that most of active sports children with low back pain (LBP) have muscle tightness around the pelvis and reduced trunk flexibility. Abnormalities in short-time inversion recovery (STIR) images on magnetic resonance imaging (MRI) can show stress fracture. Therefore, we investigated the associations among LBP, trunk flexibility, and lumbar stress fractures.
A total of 130 patients under the age of 18 years complained of LBP were investigated in STIR MRI images. Among these 130 patients, 65 cases of lumbar stress fracture were diagnosed and 65 cases were not diagnosed as a lumbar stress fracture. We compared between a group suspected of stress fracture (suspected group) and a group of stress fracture(stress fracture group)about their trunk flexibility. These groups were investigated about their initial trunk flexibility about below items; Finger floor distance (FFD), Heel to buttock distance (HBD), straight leg raising (SLR).
Significant differences were observed between suspected group and stress fracture group about every items; SLR (P < 0.001), FFD (P < 0.01), HBD (P < 0.002). Most cases of stress fracture group had reduced trunk flexibility, and low flexibility in pelvic area muscles was observed in 93.8% (61/65) of cases at the initial examination. Otherwise, that of suspected group was 73.8%(48/65).
Most patients of lumbar stress fracture had reduced trunk flexibility, and their reduced trunk flexibility might not be caused by LBP. In the early diagnosis of lumbar stress fractures using STIR MRI images, there were indicated that reduced trunk flexibility was one of helpful item for lumbar stress fracture.
我们注意到，大多数患有腰痛（LBP）的活跃运动儿童骨盆周围肌肉紧张，躯干灵活性降低。磁共振成像（MRI）上的短时反转恢复（STIR）图像异常可显示应力性骨折。因此，我们研究了腰痛、躯干灵活性和腰椎应力性骨折之间的关联。
对130例18岁以下主诉腰痛的患者进行STIR MRI图像检查。在这130例患者中，65例被诊断为腰椎应力性骨折，65例未被诊断为腰椎应力性骨折。我们比较了疑似应力性骨折组（疑似组）和应力性骨折组在躯干灵活性方面的差异。对这些组的初始躯干灵活性进行了以下项目的调查：手指触地距离（FFD）、足跟到臀部距离（HBD）、直腿抬高（SLR）。
疑似组和应力性骨折组在每个项目上均观察到显著差异；SLR（P<0.001）、FFD（P<0.01）、HBD（P<0.002）。应力性骨折组的大多数病例躯干灵活性降低，在初次检查时，93.8%（61/65）的病例骨盆区域肌肉灵活性较低。否则，疑似组为73.8%（48/65）。
大多数腰椎应力性骨折患者躯干灵活性降低，其躯干灵活性降低可能不是由腰痛引起的。在使用STIR MRI图像早期诊断腰椎应力性骨折时，表明躯干灵活性降低是腰椎应力性骨折的一个有用指标。
