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基于日本山村的人群队列研究的放射学腰椎骨关节炎的新型元素分级系统。

Novel elemental grading system for radiographic lumbar spondylosis in a population based-cohort study of a Japanese mountain village.

机构信息

Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, Tsu, Mie, Japan.

出版信息

PLoS One. 2022 Jun 28;17(6):e0270282. doi: 10.1371/journal.pone.0270282. eCollection 2022.

DOI:10.1371/journal.pone.0270282
PMID:35763521
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9239436/
Abstract

PURPOSE

Lumbar radiography is a primary screening tool for lumbar spondylosis (LS). Kellgren-Lawrence (KL) classification is widely used to evaluate LS; however, it cannot individually evaluate each radiographic feature. The purpose of this study was to 1) evaluate radiographic LS using a novel elemental grading system and 2) investigate the relationship between the grades of radiographic LS and low back pain (LBP) in a population-based cohort study.

METHODS

A total of 260 (75 men, 185 women; mean age, 71.5 ± 8.7 years) participants were included in this study. Participants were divided into two groups according to the presence of LBP (LBP- and LBP+ groups). Radiographic features, including osteophyte (OP), disc height narrowing (DHN), vertebral sclerosis (VS), and spondylolisthesis (SL), were classified between grades of 0-2 grades according to the extent of radiographic changes. The sum of grades at each intervertebral level was designated as the intervertebral grade (IG).

RESULTS

Intra- and inter-observer reliability (kappa coefficient) of OP, DHN, VS, and SL were 0.82-0.92. OP, DHN, VS, and IG grades were significantly higher in the LBP+ group than in the LBP- group. There were no significant differences in KL grades between the LBP- and LBP+ groups. Logistic regression analysis demonstrated that VS grade was a significant independent factor associated with LBP.

CONCLUSION

The novel elemental grading system of LS would reflect LBP more accurately than the KL classification by individually evaluating each radiographic feature.

摘要

目的

腰椎 X 线摄影是腰椎颈椎病（LS）的主要筛查工具。Kellgren-Lawrence（KL）分级广泛用于评估 LS；然而，它不能单独评估每个影像学特征。本研究的目的是 1）使用新的元素分级系统评估放射学 LS，2）在基于人群的队列研究中研究放射学 LS 分级与腰痛（LBP）之间的关系。

方法

本研究共纳入 260 名（75 名男性，185 名女性；平均年龄 71.5±8.7 岁）参与者。根据是否存在腰痛（LBP-和 LBP+组）将参与者分为两组。根据影像学改变的程度，将骨赘（OP）、椎间盘高度狭窄（DHN）、椎体硬化（VS）和脊椎滑脱（SL）等影像学特征分为 0-2 级。每个椎间水平的分级总和指定为椎间分级（IG）。

结果

OP、DHN、VS 和 SL 的观察者内和观察者间可靠性（kappa 系数）为 0.82-0.92。LBP+组的 OP、DHN、VS 和 IG 分级明显高于 LBP-组。LBP-和 LBP+组之间 KL 分级无显著差异。Logistic 回归分析表明，VS 分级是与 LBP 相关的独立显著因素。

结论

新的 LS 元素分级系统通过单独评估每个影像学特征，比 KL 分级更能准确反映 LBP。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/32ed/9239436/e45a17456d04/pone.0270282.g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/32ed/9239436/5d720870634f/pone.0270282.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/32ed/9239436/0fb2dbf36a01/pone.0270282.g002.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/32ed/9239436/e45a17456d04/pone.0270282.g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/32ed/9239436/5d720870634f/pone.0270282.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/32ed/9239436/0fb2dbf36a01/pone.0270282.g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/32ed/9239436/a4907e7adce3/pone.0270282.g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/32ed/9239436/57af30424d27/pone.0270282.g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/32ed/9239436/3e76e88ef0a1/pone.0270282.g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/32ed/9239436/e45a17456d04/pone.0270282.g006.jpg

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J Korean Neurosurg Soc. 2017 Jan 1;60(1):67-74. doi: 10.3340/jkns.2016.0505.007. Epub 2016 Dec 29.
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Prevalence of lumbar spondylosis and its association with low back pain among community-dwelling Japanese women.
社区居住的日本女性腰椎病患病率及其与腰痛的关联。
BMC Musculoskelet Disord. 2016 Dec 1;17(1):493. doi: 10.1186/s12891-016-1343-x.
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Risk factors for lumbar intervertebral disc height narrowing: a population-based longitudinal study in the elderly.腰椎间盘高度变窄的风险因素：一项基于人群的老年人纵向研究。
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