Department of Neurosurgery, Pohang Stroke & Spine Hospital, 352 Huimang-daero, Namgu, Pohang, Gyeong-sang bukdo, 37659, Republic of Korea.
Sci Rep. 2023 Oct 25;13(1):18303. doi: 10.1038/s41598-023-45623-0.
Leg pain can be caused by both lumbar spinal disease and chronic venous disorder (CVD) of leg veins, but their clinical differences have not been thoroughly investigated. This study aimed to determine the incidence of CVD among patients visiting a spine center for leg pain. A total of 196 cases underwent ultrasound examination with a diagnosis rate were 85.7% (168 cases). CVD-diagnosed cases were divided into two groups based on the severity of lumbar spinal disease. The Clinical grades, symptom areas, and symptom types were compared. The differences in symptom improvements with vasoactive medication were also assessed. The most common symptom area was calf then the foot in CVD, while calf then thigh in lumbar spinal disease. Tingling-paresthesia was the most common symptom type for both, with pain and cramping similarly common in CVD and pain more common than cramping in lumbar spinal disease. Considering that the majority of CVD cases (78.6%) had minor cutaneous changes and almost half of cases (41.7%) had refluxes only in tributaries, significant differences in symptom improvement in CVD-dominant group suggested that early-stage venous reflux is a symptomatic disease and a possible cause of leg pain and other symptoms.
腿部疼痛可由腰椎疾病和腿部静脉慢性静脉疾病（CVD）引起，但它们的临床差异尚未得到彻底研究。本研究旨在确定因腿部疼痛就诊于脊柱中心的患者中 CVD 的发病率。共有 196 例患者接受了超声检查，诊断率为 85.7%（168 例）。根据腰椎疾病的严重程度，将 CVD 诊断病例分为两组。比较了临床分级、症状区域和症状类型。还评估了血管活性药物治疗症状改善的差异。在 CVD 中，最常见的症状区域是小腿，然后是足部，而在腰椎疾病中，最常见的症状区域是小腿，然后是大腿。刺痛感觉异常是两者最常见的症状类型，疼痛和抽筋在 CVD 中同样常见，而在腰椎疾病中疼痛比抽筋更常见。考虑到大多数 CVD 病例（78.6%）仅有轻微的皮肤改变，几乎一半的病例（41.7%）仅在属支中有反流，CVD 主导组症状改善的显著差异表明早期静脉反流是一种有症状的疾病，可能是腿部疼痛和其他症状的原因。
