Department of Orthopedic Surgery, Far Eastern Memorial Hospital, New Taipei City 220, Taiwan.
Department of Senior Services Industry Management, Minghsin University of Science and Technology, Hsinchu 304, Taiwan.
Int J Environ Res Public Health. 2023 Jan 9;20(2):1152. doi: 10.3390/ijerph20021152.
Background: Although hallux valgus is known to cause lower-back pain, the association between hallux valgus and spinal degenerative disease remains unclear. Methods: A retrospective cohort study was conducted between 1 January 2000 and 31 December 2015 using data from the Longitudinal Health Insurance Database in Taiwan. After propensity score matching for age, sex, and some potential comorbidities, 1000 individuals newly diagnosed with hallux valgus were enrolled in the study group, while 1000 individuals never diagnosed with hallux valgus served as the control group. Both groups were followed up until 2015 to evaluate the incidence of hallux valgus. Kaplan-Meier analysis was used to determine the cumulative incidence of hallux valgus, while the Cox proportional hazard model was adopted to estimate the hazard ratio (HR) and adjusted hazard ratio (aHR) with 95% confidence intervals (CIs). Results: The incidence densities of spinal degeneration in the hallux valgus and non-hallux valgus groups were 73.10 and 42.63 per 1000 person-years, respectively. An increased risk of spinal degenerative changes was associated with hallux valgus (adjusted HR = 1.75, 95% CI = 1.50−2.05). Age- and sex-stratified analyses showed a significantly higher risk of spinal degeneration in the hallux valgus group. Moreover, sub-outcome evaluations revealed significantly higher risks of spondylosis (aHR = 2.01, 95% CI = 1.55−2.61), intervertebral disorder (aHR = 2.27, 95% CI = 1.62−3.17), and spinal stenosis (aHR = 1.24, 95% CI = 1.47−1.76). There was also an increased risk of spinal degenerative change in those with hallux valgus without surgical intervention (aHR = 1.95, 95% CI = 1.66−2.99, p < 0.001). Conclusions: Hallux valgus was associated with increased risk of degenerative spinal changes and other spinal disorders.
虽然拇外翻已知会引起下背痛，但拇外翻与脊柱退行性疾病之间的关联尚不清楚。
本研究采用回顾性队列研究设计，数据来源于台湾纵向健康保险数据库，研究时间为 2000 年 1 月 1 日至 2015 年 12 月 31 日。对年龄、性别和一些潜在合并症进行倾向评分匹配后，将 1000 例新诊断为拇外翻的患者纳入研究组，而 1000 例从未诊断为拇外翻的患者作为对照组。两组患者均随访至 2015 年，以评估拇外翻的发生率。Kaplan-Meier 分析用于确定拇外翻的累积发生率，Cox 比例风险模型用于估计风险比（HR）和调整后的风险比（aHR）及其 95%置信区间（CI）。
在拇外翻组和非拇外翻组中，脊柱退行性变的发生率密度分别为 73.10 和 42.63/1000 人年。与拇外翻相关的脊柱退行性改变风险增加（调整后的 HR = 1.75，95%CI = 1.50−2.05）。年龄和性别分层分析显示，拇外翻组的脊柱退行性变风险显著更高。此外，亚组结果评估显示，脊柱骨关节炎（aHR = 2.01，95%CI = 1.55−2.61）、椎间盘疾病（aHR = 2.27，95%CI = 1.62−3.17）和脊柱狭窄症（aHR = 1.24，95%CI = 1.47−1.76）的风险显著增加。未接受手术干预的拇外翻患者也有更高的脊柱退行性改变风险（aHR = 1.95，95%CI = 1.66−2.99，p < 0.001）。
拇外翻与退行性脊柱改变和其他脊柱疾病的风险增加有关。
