Bucklin Mary A, Gehrke Eric C, Westrick Jennifer C, Gottlieb Michael, Martin John T
Rush University Medical Center, Chicago, IL, USA.
Rosalind Franklin University, North Chicago, IL, USA.
Osteoarthr Cartil Open. 2024 Oct 16;6(4):100529. doi: 10.1016/j.ocarto.2024.100529. eCollection 2024 Dec.
Chronic low back pain (cLBP) is a complex disease with biological, psychological, and social components and the complex interactions of these components are poorly understood. Chronic psychological stress (CPS) (anxiety, depression, etc.) and pathological changes in spinal tissue (osteoporosis, disc degeneration, etc.) are frequently and independently associated with cLBP, yet their explicit relationship has not been collectively reviewed. The objective of this scoping review is to investigate the current state of research on how CPS may impact spinal tissue pathology.
Five steps were utilized to conduct this scoping review: 1) identify a research objective and establish a search strategy, 2) identify research articles, 3) select research articles that meet search criteria, 4) extract data, 5) summarize and report results.
We identified N = 56 articles relating CPS to spinal pathology. Of those that identified a relationship between CPS and spine pathology (N = 39), most (N = 24) described decreased lumbar vertebral bone mineral density (BMD) between depression and control groups. Animal studies (N = 8) were limited to mice and confirmed a causal relationship between CPS and lower vertebral BMD. Only a few additional human studies (N = 9) documented relationships between other various forms of CPS and spinal tissue pathologies.
This scoping review documents evidence of a relationship between CPS and decreased spine health in humans as well as a causal relationship between the initiation of CPS and decreased BMD in animals. As few studies evaluated disease in other spinal anatomy in relationship to CPS, future work in this area is warranted. Further exploration of CPS beyond depression is warranted as well.
慢性下腰痛（cLBP）是一种具有生物学、心理学和社会因素的复杂疾病，而这些因素之间的复杂相互作用尚不清楚。慢性心理应激（CPS）（焦虑、抑郁等）和脊柱组织的病理变化（骨质疏松、椎间盘退变等）经常且独立地与cLBP相关，但它们之间的明确关系尚未得到综合综述。本范围综述的目的是调查关于CPS如何影响脊柱组织病理学的研究现状。
采用五个步骤进行本范围综述：1）确定研究目标并制定检索策略，2）识别研究文章，3）选择符合检索标准的研究文章，4）提取数据，5）总结并报告结果。
我们确定了N = 56篇将CPS与脊柱病理学相关联的文章。在那些确定CPS与脊柱病理学之间存在关联的文章中（N = 39），大多数（N = 24）描述了抑郁组和对照组之间腰椎骨密度（BMD）降低。动物研究（N = 8）仅限于小鼠，并证实了CPS与较低椎体BMD之间的因果关系。只有少数其他人体研究（N = 9）记录了其他各种形式的CPS与脊柱组织病理学之间的关系。
本范围综述记录了CPS与人类脊柱健康下降之间存在关联的证据，以及CPS引发与动物BMD降低之间的因果关系。由于很少有研究评估其他脊柱解剖结构中的疾病与CPS的关系，因此该领域未来的工作是必要的。对除抑郁之外的CPS进行进一步探索也是必要的。
