Erdoğan Barış, Kolutek Ay Bilgehan
Neurosurgery, Şanlıurfa Education and Training Hospital, Şanlıurfa, TUR.
Physical Therapy and Rehabilitation, Şanlıurfa Education and Training Hospital, Şanlıurfa, TUR.
Cureus. 2023 Mar 23;15(3):e36601. doi: 10.7759/cureus.36601. eCollection 2023 Mar.
Chronic low back pain in children is a condition that should be investigated. In this study, we examined the effects of agricultural work on imaging results, risk factors, night pain, and vitamin D levels in children and adolescents with chronic low back pain.
The study included 133 patients who presented to the Physical Medicine and Rehabilitation and Neurosurgery outpatient clinics with low back pain that had lasted more than three months. The patients were evaluated based on the duration of their low back pain, the presence of night pain, a family history of low back pain, their employment status, local or radicular pain, and their body mass index (BMI). A physical examination was carried out to look into the etiologies of low back pain. Appropriate imaging, such as x-ray radiography, magnetic resonance imaging (MRI), and computed tomography (CT), was performed for the patients. Blood samples were collected from patients to assess inflammatory pathologies and vitamin D levels.
The 133 patients in the study ranged in age from seven to 16 years, with a mean age of 14.3 + 1.9 years. Further, 60.2% (n = 80) of the cases were male, while 39.8% (n = 53) were female. Imaging revealed findings in 59.4% of the patients. In 97.7% of the participants, D hypovitaminosis was detected. There was no significant relationship between the patients' imaging findings and vitamin D deficiency, family history, BMI, and employment status (p = 0.441, 0.147, 0.082, 0.605). The relationship between family history, employment status, and night pain was statistically significant (p < 0.001). There was no statistically significant relationship between night pain and vitamin D deficiency (p = 0.667).
Mechanical strain due to agricultural work and family history was found to be associated with night pain in patients with chronic low back pain in our study. The most important finding of this study is that night pain, which is considered a red flag, can occur in both inflammatory pathologies and situations causing mechanical low back pain, and risk factors should be thoroughly investigated. Studies with patients who have sufficient vitamin D will help to clarify the relationship between chronic low back pain and vitamin D.
儿童慢性腰痛是一种需要进行调查的病症。在本研究中，我们考察了农业劳动对患有慢性腰痛的儿童和青少年的影像结果、风险因素、夜间疼痛及维生素D水平的影响。
该研究纳入了133例因腰痛持续超过三个月而前来物理医学与康复科及神经外科门诊就诊的患者。基于患者的腰痛持续时间、夜间疼痛情况、腰痛家族史、就业状况、局部或放射性疼痛以及体重指数（BMI）对患者进行评估。进行体格检查以探究腰痛的病因。为患者进行了适当的影像检查，如X线摄影、磁共振成像（MRI）和计算机断层扫描（CT）。采集患者血液样本以评估炎症病变和维生素D水平。
研究中的133例患者年龄在7至16岁之间，平均年龄为14.3±1.9岁。此外，60.2%（n = 80）的病例为男性，39.8%（n = 53）为女性。影像检查在59.4%的患者中发现了异常。在97.7%的参与者中检测到维生素D缺乏。患者的影像检查结果与维生素D缺乏、家族史、BMI及就业状况之间无显著关系（p = .441、.147、.e082、.605）。家族史、就业状况与夜间疼痛之间的关系具有统计学意义（p < .001）。夜间疼痛与维生素D缺乏之间无统计学意义的关系（p = .667）。
在我们的研究中，发现农业劳动导致的机械性劳损和家族史与慢性腰痛患者的夜间疼痛有关。本研究最重要的发现是，被视为危险信号的夜间疼痛，在炎症病变和导致机械性腰痛的情况下均可能出现，应全面调查风险因素。对维生素D充足的患者进行研究将有助于阐明慢性腰痛与维生素D之间的关系。
