Department of Orthopaedic Surgery, Daegu Catholic University Medical Center, Daegu, Korea.
Clin Orthop Surg. 2019 Jun;11(2):176-182. doi: 10.4055/cios.2019.11.2.176. Epub 2019 May 9.
The incidence of facet tropism (FT) and its correlation with low back pain (LBP) have, to our knowledge, not yet been investigated among selected community-based populations who visited departments unrelated to LBP with their chief complaints unrelated to LBP. In this study, we aimed to evaluate the prevalence of FT among selected patients in whom LBP was not the chief complaint and the correlation between FT and LBP among these patients.
Among patients who underwent computed tomography during 2014 for reasons unrelated to LBP, we enrolled 462 patients who satisfied the inclusion and exclusion criteria. The degree of tropism was defined as grade 0, 1, and 2 for FT, FT+, and FT++, respectively. LBP was evaluated using a modified version of the Nordic low back pain questionnaire. For additional evaluation of dynamic LBP, the question, "Did your pain go away when lying down still or standing up straight, and did it also intensify when you bend or stretch your back?," was included in the questionnaire.
The L4-5 intervertebral area was most frequently and severely affected by FT with an incidence rate of 46.3%, and severe FT was observed in 24.7% of the patients. FT increased with age at L2-3 and L5-S1 levels. FT at L2-3 level was correlated with LBP ( = 0.035) and dynamic LBP ( = 0.033). The FT grade at L2-3 level was correlated with dynamic LBP ( = 0.022) but not with LBP ( = 0.077). The relative risk of FT at L2-3 level was 1.614 for LBP and 1.724 for dynamic LBP.
The prevalence of FT among community-based populations was 46.3% and its severe form was more frequently observed at L4-5 level (24.7%). LBP was correlated with FT at L2-3 level. The relative FT-associated risk of LBP was 1.6 at L2-3 level, and the relative L2-3 FT-associated risk of dynamic LBP was 1.724.
在以非腰痛为主要诉求、就诊科室与腰痛无关的社区人群中，关节突关节面倾斜（FT）的发生率及其与腰痛（LBP）的相关性尚未得到研究。本研究旨在评估非腰痛主诉患者中 FT 的发生率以及这些患者中 FT 与 LBP 的相关性。
在 2014 年因非腰痛原因接受计算机断层扫描的患者中，我们纳入了 462 名符合纳入和排除标准的患者。FT 的倾斜程度定义为 FT+和 FT++分别为 0、1 和 2 级。使用改良北欧腰痛问卷评估 LBP。为了进一步评估动态性腰痛，问卷中还包括“当您平躺或站直时，疼痛是否消失，当您弯腰或伸展背部时，疼痛是否加剧？”这一问题。
L4-5 椎间区是最常且最严重受到 FT 影响的部位，发生率为 46.3%，24.7%的患者出现严重 FT。FT 在 L2-3 和 L5-S1 水平上随年龄增长而增加。L2-3 水平的 FT 与 LBP（ = 0.035）和动态性 LBP（ = 0.033）相关。L2-3 水平的 FT 分级与动态性 LBP（ = 0.022）相关，但与 LBP 无关（ = 0.077）。L2-3 水平的 FT 相对风险为 LBP 的 1.614 倍，为动态性 LBP 的 1.724 倍。
社区人群中 FT 的发生率为 46.3%，其严重形式更常见于 L4-5 水平（24.7%）。LBP 与 L2-3 水平的 FT 相关。L2-3 水平的 FT 与 LBP 的相对风险为 1.6，L2-3 水平的 FT 与动态性 LBP 的相对风险为 1.724。
