Sydney Medical School, School of Public Health, The University of Sydney, PO Box M179, Missenden Rd, NSW 2050, Australia.
Sydney Medical School, School of Public Health, The University of Sydney, PO Box M179, Missenden Rd, NSW 2050, Australia.
Spine J. 2018 Sep;18(9):1715-1721. doi: 10.1016/j.spinee.2018.05.018. Epub 2018 May 21.
Low back pain (LBP) is a highly prevalent condition and it is associated with significant disability and work absenteeism worldwide. A variety of environmental and individual characteristics have been reported to increase the risk of LBP. To our knowledge, there has been no previous attempt to summarize the evidence from existing systematic reviews of risk factors for LBP or sciatica.
To provide an overview of risk factors for LBP, we completed an umbrella review of the evidence from existing systematic reviews.
An umbrella review was carried out.
A systematic literature search was conducted in MEDLINE, EMBASE, PubMed PsychINFO, and CINAHL databases. To focus on the most recent evidence, we only included systematic reviews published in the last 5 years (2011-2016) examining any risk factor for LBP or sciatica. Only systematic reviews of cohort studies enrolling participants without LBP and sciatica at baseline were included. The methodological quality of the reviews was assessed independently by two review authors, using the Assessment of Multiple Systematic Reviews tool.
We included 15 systematic reviews containing 134 cohort studies. Four systematic reviews were of high methodological quality and 11 were of moderate quality. Of the 54 risk factors investigated, 38 risk factors were significantly associated with increased risk of LBP or sciatica in at least one systematic review and the odds ratios ranged from 1.26 to 13.00. Adverse risk factors included characteristics of the individual (eg, older age), poor general health (eg, smoking), physical stress on spine (eg, vibration), and psychological stress (eg, depression).
Poor general health, physical and psychological stress, and characteristics of the person increase risk for a future episode of LBP or sciatica.
腰痛（LBP）是一种高度流行的疾病，与全球范围内的显著残疾和旷工有关。已经报道了各种环境和个体特征会增加 LBP 的风险。据我们所知，以前没有人试图总结现有的 LBP 或坐骨神经痛危险因素系统评价的证据。
为了概述 LBP 的危险因素，我们对现有的系统评价进行了伞式综述。
进行了伞式综述。
在 MEDLINE、EMBASE、PubMed PsychINFO 和 CINAHL 数据库中进行了系统文献检索。为了关注最新的证据，我们仅包括在过去 5 年内（2011-2016 年）发表的、针对任何 LBP 或坐骨神经痛危险因素的系统评价。仅包括在基线时没有 LBP 和坐骨神经痛的队列研究的系统评价。使用多系统评价评估工具独立评估了两位综述作者对综述的方法学质量。
我们纳入了 15 项包含 134 项队列研究的系统评价。有 4 项系统评价具有较高的方法学质量，11 项为中等质量。在调查的 54 个危险因素中，有 38 个危险因素在至少一项系统评价中与 LBP 或坐骨神经痛风险增加显著相关，比值比范围从 1.26 到 13.00。不利的危险因素包括个体特征（如年龄较大）、一般健康状况不佳（如吸烟）、脊柱物理应激（如振动）和心理应激（如抑郁）。
一般健康状况不佳、身体和心理应激以及个体特征会增加未来发生 LBP 或坐骨神经痛的风险。
