Department of Orthopedic Surgery, School of Medicine, Kitasato University, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0375, Japan.
Department of Rehabilitation, Kitasato University Hospital, Sagamihara, Japan.
Arch Osteoporos. 2021 Dec 4;17(1):1. doi: 10.1007/s11657-021-01045-x.
In the current study, multivariate analyses were performed to determine factors associated with low back pain (LBP) in patients with osteoporosis. Aging, high bone turnover, obesity, low trunk muscle mass, spinal global sagittal malalignment, and a high number of previous vertebral fractures were potential independent risk factors of pain-related disorders, gait disturbance, or ADL deficit due to LBP.
Patients with osteoporosis often experience low back pain (LBP) even in the absence of acute fractures. This study identifies factors that may affect questionnaires about LBP.
The data of 491 patients with osteoporosis were retrospectively reviewed. Data included patient age, sex, body mass index (BMI), bone mineral density of the lumbar spine, tartrate-resistant acid phosphatase 5b level (TRACP5b), trunk muscle mass, sagittal vertical axis (SVA), previous vertebral fractures, secondary osteoporosis, controlling nutritional status score, pain-related disorders and gait disturbance scores from the Japanese Orthopedic Association Back Pain Evaluation questionnaire (JOABPEQ), and Oswestry disability index (ODI) scores for activities of daily living (ADL) deficit. Patients with scores of 100 for each subsection of the JOABPEQ, or an ODI scores < 12 were considered to not have dysfunction (dysfunction (-) group). Multivariate analyses were used to determine variables associated with dysfunction.
Pain-related disorders score of JOABPEQ was associated with aging, high BMI, and high SVA. Aging, high TRACP5b, high BMI, low TM, high SVA, and more previous vertebral fractures were associated with gait disturbance score of JOABPEQ. ODI scores were associated with high BMI, low TM, high SVA, and more previous vertebral fractures.
Aging, high bone turnover, obesity, a low TM, spinal global sagittal malalignment, and a high number of previous VFs were potential independent risk factors of pain-related disorders or gait disturbance according to the JOABPEQ or ODI score in patients with osteoporosis.
患有骨质疏松症的患者即使没有急性骨折，也常常会出现腰痛（LBP）。本研究旨在确定可能影响与 LBP 相关问卷的因素。
回顾性分析 491 例骨质疏松症患者的临床资料，包括患者年龄、性别、体重指数（BMI）、腰椎骨密度、抗酒石酸酸性磷酸酶 5b 水平（TRACP5b）、躯干肌肉质量、矢状垂直轴（SVA）、既往椎体骨折、继发性骨质疏松症、营养状况控制评分、日本矫形协会腰痛评估问卷（JOABPEQ）中的疼痛相关障碍和步态障碍评分以及日常生活活动（ADL）缺损的 Oswestry 残疾指数（ODI）评分。JOABPEQ 各部分评分≥100 分或 ODI 评分＜12 分的患者被认为无功能障碍（无功能障碍（-）组）。采用多变量分析确定与功能障碍相关的变量。
JOABPEQ 的疼痛相关障碍评分与年龄、高 BMI 和高 SVA 相关。JOABPEQ 的步态障碍评分与年龄、高 TRACP5b、高 BMI、低 TM、高 SVA 和更多既往椎体骨折相关。ODI 评分与高 BMI、低 TM、高 SVA 和更多既往椎体骨折相关。
根据骨质疏松症患者的 JOABPEQ 或 ODI 评分，年龄增长、骨转换增加、肥胖、TM 低、脊柱整体矢状面失平衡、既往椎体骨折次数多是疼痛相关障碍或步态障碍的潜在独立危险因素。
