Department of Orthopaedic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, 79# Qingchun Road, Hangzhou, Zhejiang, 310003, China.
Center of Orthopedics, The 903rd Hospital of People's Liberation Army, Hangzhou, Zhejiang, China.
Neuroradiology. 2024 Sep;66(9):1649-1656. doi: 10.1007/s00234-024-03391-2. Epub 2024 Jun 14.
To determine the characteristics of lumbar foraminal stenosis (LFS) on magnetic resonance (MR) images and their association with back pain and radiating leg pain in a population-based sample of Chinese subjects.
This study was an extension of the Hangzhou Lumbar Spine Study, a cross-sectional study focusing on back pain and lumbar spine MR imaging findings. Questionnaire data, including demographics, lifestyle, occupational exposures, back pain and radiating leg pain were included. On lumbar spine MR images, disc degeneration was assessed using Pfirrmann grade and Modic changes were evaluated. Using Lee's scale, the L3-S1 intervertebral foramina were evaluated, with grade 2-3 representing substantial LFS and grade 0-1 no LFS. Characteristics of LFS were noted, and associations of LFS with back pain and radiating leg pain were examined.
Among the 644 study subjects, 141 (21.9%) had at least one LFS, and its occurrence was associated with greater age (OR = 1.93 for each 10 years, p < 0.001). Substantial LFS was associated with the presence of back pain (OR = 1.92, p = 0.001) and the intensity of the worst back pain (Coef = 8.30, p < 0.001) over the past 12 months, and disabling back pain during their lifetime (OR = 2.25, p < 0.001). Substantial LFS was also associated with leg pain (OR = 14.27, p < 0.001), with a sensitivity of 75.7% for the presence of radiating leg pain and a specificity of 81.4%.
Substantial LFS on MR images was a common age-related degenerative phenotype in adults, and appears to be an independent risk factor for back pain and leg pain.
在一个基于人群的中国人群样本中，确定磁共振成像（MR）图像上腰椎管狭窄症（LFS）的特征及其与腰痛和放射性腿痛的关系。
本研究是杭州腰椎研究的延伸，是一项侧重于腰痛和腰椎磁共振成像结果的横断面研究。问卷调查数据包括人口统计学、生活方式、职业暴露、腰痛和放射性腿痛。在腰椎 MR 图像上，使用 Pfirrmann 分级评估椎间盘退变，评估 Modic 改变。使用 Lee 量表评估 L3-S1 椎间孔，分级 2-3 表示有明显的 LFS，分级 0-1 表示无 LFS。记录 LFS 的特征，并检查 LFS 与腰痛和放射性腿痛的关系。
在 644 名研究对象中，有 141 名（21.9%）至少有一个 LFS，其发生与年龄较大有关（每增加 10 岁，OR=1.93，p<0.001）。严重的 LFS 与腰痛（OR=1.92，p=0.001）和过去 12 个月最严重腰痛的强度（Coef=8.30，p<0.001）以及一生中致残性腰痛有关（OR=2.25，p<0.001）。严重的 LFS 也与腿痛有关（OR=14.27，p<0.001），放射性腿痛的存在具有 75.7%的敏感性，特异性为 81.4%。
MR 图像上的严重 LFS 是成年人常见的与年龄相关的退行性表型，似乎是腰痛和腿痛的独立危险因素。
