Tatsumura Masaki, Gamada Hisanori, Ishimoto Ryu, Okuwaki Shun, Eto Fumihiko, Ogawa Takeshi, Mammoto Takeo, Hirano Atsushi
Department of Orthopaedic Surgery and Sports Medicine, Tsukuba University Hospital Mito Clinical Education and Training Center, Mito Kyodo General Hospital, Japan.
J Rural Med. 2018 Nov;13(2):105-109. doi: 10.2185/jrm.2967. Epub 2018 Nov 29.
The aim of this study was to determine the prevalence of curable and pseudoarthrosis stages of adolescent lumbar spondylolysis under high school students complaining of and seeking medical consultation for low back pain. We analyzed age, sex, morbidity, presence of spina bifida occulta (SBO), and competitive sport discipline of patients with lumbar spondylolysis. We then stratified their pathological stage using a modified classification system via magnetic resonance imaging and computed tomography. Of 507 patients, 451 lesions in 268 patients were diagnosed with lumbar spondylolysis (average age, 14.7 years; sex ratio, 215:53 male/female). Morbidity levels were as follows: L1, 1 lesion in 1 patient; L2, 9 lesions in 5 patients; L3, 38 lesions in 25 patients; L4, 106 lesions in 74 patients; L5, 297 lesions in 189 patients, and SBO verified in 111 patients. A total of 264 patients played a specific sport: baseball, 93; soccer, 49; volleyball, 21; track and field, 21; basketball, 20; others, 164. The prevalence of curable- and pseudoarthrosis-stage lumbar spondylolysis was 206 lesions in 142 patients, and 141 lesions in 87 patients, respectively. With 59.3% of patients having curable-stage lumbar spondylolysis, adolescent athletes with low back pain are urged to seek consultation. Furthermore, clinicians should perform magnetic resonance imaging to avoid misdiagnosis.
本研究旨在确定在因腰痛而寻求医疗咨询的高中生中,青少年腰椎峡部裂可治愈阶段和假关节形成阶段的患病率。我们分析了腰椎峡部裂患者的年龄、性别、发病率、隐性脊柱裂(SBO)的存在情况以及竞技运动项目。然后,我们通过磁共振成像和计算机断层扫描,使用改良的分类系统对他们的病理阶段进行分层。在507例患者中,268例患者的451处病变被诊断为腰椎峡部裂(平均年龄14.7岁;性别比为男性215例/女性53例)。发病率情况如下:L1,1例患者1处病变;L2,5例患者9处病变;L3,25例患者38处病变;L4,74例患者106处病变;L5,189例患者297处病变,111例患者经证实存在SBO。共有264例患者从事特定运动:棒球93例;足球49例;排球21例;田径21例;篮球20例;其他164例。腰椎峡部裂可治愈阶段和假关节形成阶段的患病率分别为142例患者中的206处病变和87例患者中的141处病变。鉴于59.3%的患者处于腰椎峡部裂可治愈阶段,敦促有腰痛的青少年运动员寻求咨询。此外,临床医生应进行磁共振成像检查以避免误诊。