Qualcomm Health Center, Stanford Health Care, San Diego, California, United States of America.
Publications Department, National University of Health Sciences, Lombard, Illinois, United States of America.
PLoS One. 2018 Jun 1;13(6):e0197987. doi: 10.1371/journal.pone.0197987. eCollection 2018.
The purpose of this review was to identify risk factors, prognostic factors, and comorbidities associated with common spinal disorders.
A scoping review of the literature of common spinal disorders was performed through September 2016. To identify search terms, we developed 3 terminology groups for case definitions: 1) spinal pain of unknown origin, 2) spinal syndromes, and 3) spinal pathology. We used a comprehensive strategy to search PubMed for meta-analyses and systematic reviews of case-control studies, cohort studies, and randomized controlled trials for risk and prognostic factors and cross-sectional studies describing associations and comorbidities.
Of 3,453 candidate papers, 145 met study criteria and were included in this review. Risk factors were reported for group 1: non-specific low back pain (smoking, overweight/obesity, negative recovery expectations), non-specific neck pain (high job demands, monotonous work); group 2: degenerative spinal disease (workers' compensation claim, degenerative scoliosis), and group 3: spinal tuberculosis (age, imprisonment, previous history of tuberculosis), spinal cord injury (age, accidental injury), vertebral fracture from osteoporosis (type 1 diabetes, certain medications, smoking), and neural tube defects (folic acid deficit, anti-convulsant medications, chlorine, influenza, maternal obesity). A range of comorbidities was identified for spinal disorders.
Many associated factors for common spinal disorders identified in this study are modifiable. The most common spinal disorders are co-morbid with general health conditions, but there is a lack of clarity in the literature differentiating which conditions are merely comorbid versus ones that are risk factors. Modifiable risk factors present opportunities for policy, research, and public health prevention efforts on both the individual patient and community levels. Further research into prevention interventions for spinal disorders is needed to address this gap in the literature.
本综述旨在确定常见脊柱疾病的相关风险因素、预后因素和合并症。
通过 2016 年 9 月对常见脊柱疾病的文献进行了范围界定的综述。为了确定检索词，我们为病例定义制定了 3 个术语组：1）原因不明的脊柱疼痛，2）脊柱综合征，和 3）脊柱病理。我们使用全面的策略在 PubMed 上搜索病例对照研究、队列研究和随机对照试验的荟萃分析和系统评价，以及描述关联和合并症的横断面研究。
在 3453 篇候选论文中，有 145 篇符合研究标准并纳入本综述。报告了以下 1 组的风险因素：非特异性下腰痛（吸烟、超重/肥胖、负面恢复预期）、非特异性颈痛（高工作要求、单调工作）；2 组：退行性脊柱疾病（工人赔偿要求、退行性脊柱侧凸）和 3 组：脊柱结核（年龄、监禁、既往结核病史）、脊髓损伤（年龄、意外损伤）、骨质疏松性椎体骨折（1 型糖尿病、某些药物、吸烟）和神经管缺陷（叶酸缺乏、抗惊厥药物、氯、流感、母体肥胖）。确定了一系列与脊柱疾病相关的合并症。
本研究确定了许多常见脊柱疾病的相关因素是可以改变的。最常见的脊柱疾病与一般健康状况并存，但文献中缺乏明确区分哪些疾病仅是合并症，哪些是危险因素。可改变的风险因素为个人和社区层面的政策、研究和公共卫生预防工作提供了机会。需要进一步研究脊柱疾病的预防干预措施，以弥补这一文献空白。
