美国儿童和青少年背痛的流行病学。
The Epidemiology of Back Pain in American Children and Adolescents.
机构信息
Pediatric Orthopedic Surgery Division, Hospital for Special Surgery, NY.
Donald and Barbara Zucker School of Medicine, Hofstra/Northwell, NY.
出版信息
Spine (Phila Pa 1976). 2020 Aug 15;45(16):1135-1142. doi: 10.1097/BRS.0000000000003461.
STUDY DESIGN
Cross-sectional survey.
OBJECTIVE
To determine the prevalence of back pain in American children and adolescents, with a focus on anatomic region, duration, severity, and treatment patterns, and to investigate for any predictive variables.
SUMMARY OF BACKGROUND DATA
No study has examined the prevalence of back pain in American children and adolescents in the last 15 years. Because the prevalence of back pain varies greatly by country and year of investigation, previous studies are not generalizable.
METHODS
A United States epidemiologic cross-sectional survey-based investigation was performed in children and adolescents ages 10 and 18 years old, equally split by age and sex, and representing census-weighted distributions of state of residence, race/ethnicity, and health insurance status. Prevalence of back pain was evaluated and described.
RESULTS
In total, 1236 (33.7%) participants reported experiencing back pain within the last year and 325 (8.9%) reported severe back pain within the last year. Prevalence of back pain increased with age and was significantly more common in females, P < 0.001 for both. Treatment for back pain was sought by 505 (40.9%) of the participants with pain, of which physical therapy was the most common. Invasive procedural treatment (e.g., injections, surgery) were rare and comprised only 61 (1.6%) of study participants. In addition, government insurance and lack of insurance coverage was associated with low treatment seeking behavior compared to private insurance users (P = 0.010 and P = 0.006, respectively).
CONCLUSION
Despite how commonly it presents, the majority of young patients with back pain do not report procedural treatment such as injections or surgery. However, because many American children and adolescents seek treatment, future research on the etiology, treatment, and prevention of back pain in children and adolescents is essential to reducing a common and financially demanding problem.
LEVEL OF EVIDENCE
研究设计
横断面调查。
目的
确定美国儿童和青少年背痛的患病率，重点关注解剖区域、持续时间、严重程度和治疗模式，并探讨任何预测变量。
背景数据概要
在过去 15 年中，没有研究检查过美国儿童和青少年背痛的患病率。由于背痛的患病率因国家和调查年份而异，因此以前的研究不可推广。
方法
对年龄在 10 至 18 岁的儿童和青少年进行了一项基于美国流行病学横断面调查的研究，按年龄和性别平均分配，并代表居住州、种族/族裔和健康保险状况的人口加权分布。评估和描述了背痛的患病率。
结果
共有 1236 名（33.7%）参与者报告在过去一年中经历过背痛，325 名（8.9%）报告在过去一年中经历过严重背痛。背痛的患病率随年龄增长而增加，女性更为常见，两者均 P < 0.001。505 名（40.9%）有疼痛的参与者寻求背痛治疗，其中物理治疗最为常见。侵入性治疗（例如，注射、手术）很少见，仅占研究参与者的 61 名（1.6%）。此外，与私人保险使用者相比，政府保险和缺乏保险覆盖与寻求治疗的行为较低相关（P = 0.010 和 P = 0.006）。
结论
尽管背痛很常见，但大多数患有背痛的年轻患者并不报告接受注射或手术等程序性治疗。然而，由于许多美国儿童和青少年寻求治疗，因此对儿童和青少年背痛的病因、治疗和预防进行未来研究对于减少这一常见且耗费大量资金的问题至关重要。
证据水平
4 级。
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