Thorseth Ingrid, Nordberg Cecilie Lerche, Boesen Mikael, Bliddal Henning, Fournier Gilles Ludger, Hansen Philip, Nielsen Sabrina Mai, Hansen Bjarke Brandt
Department of Rheumatology, The Parker Institute, Copenhagen University Hospital, Bispebjerg and Frederiksberg Hospital, Nordre Fasanvej 57, 2000, Copenhagen, Denmark.
Department of Anesthesiology, Nykøbing Falster Hospital, Nykøbing Falster, Region Zealand, Denmark.
Eur Spine J. 2025 Mar;34(3):1071-1078. doi: 10.1007/s00586-024-08577-z. Epub 2024 Nov 28.
To investigate positional lumbar changes by weight-bearing MRI in low back pain (LBP) patients with hypermobile joints (Beighton score ≥ 4).
Patients referred to weight-bearing MRI went through a clinical examination, including Beighton's test, answered back pain-related questionnaires, and were hereafter imaged in supine and standing in a 0.25-T MRI unit. All MRI exams were evaluated for degenerative findings i.e., herniations, disc degeneration, spinal stenosis, disc degeneration, and spondylolisthesis. Subsequently, the lumbar lordosis angle, the sacral angle, and all spondylolisthesis' slippages were measured for both positions.
Of 257 LBP patients, Beighton score ≥ 4 were seen in 48 patients, and these included more females (81.3% vs. 51.7%), younger patients (mean difference [MD]: -8.1 years), and had less degenerated lumbar discs (sum-score MD: -0.9). No difference between groups in degenerative MRI findings was found, although, a non-significant tendency (p = 0.072) to a higher number of anterolisthesis in the hypermobile patients. The hypermobile patients had a greater lordosis angle both during supine and standing and a greater sacral angle in supine, however, changes in the angles between supine and standing were without difference between groups. A sensitivity analysis adjusted for gender and age confirmed these findings.
Hypermobility in LBP patients was associated with being female, younger, having increased lumbar lordosis both during standing and in supine, however, was not associated with increased back pain, anterolisthesis grade or more severe lumbar changes between positions.
通过负重MRI研究关节活动度过大（Beighton评分≥4）的下腰痛（LBP）患者的腰椎位置变化。
接受负重MRI检查的患者进行了临床检查，包括Beighton试验，回答了与背痛相关的问卷，然后在0.25-T MRI设备中进行仰卧位和站立位成像。所有MRI检查均评估了退行性病变，即椎间盘突出、椎间盘退变、椎管狭窄、椎体滑脱。随后，测量两个体位的腰椎前凸角、骶骨角以及所有椎体滑脱的滑移程度。
在257例LBP患者中，48例患者的Beighton评分≥4，其中女性更多（81.3%对51.7%），患者更年轻（平均差[MD]：-8.1岁），腰椎间盘退变程度更低（总分MD：-0.9）。尽管关节活动度过大的患者中前滑脱数量有更高的非显著趋势（p = 0.072），但两组在MRI退行性病变表现上未发现差异。关节活动度过大的患者在仰卧位和站立位时前凸角都更大，仰卧位时骶骨角更大，然而，仰卧位和站立位之间角度的变化在两组之间没有差异。对性别和年龄进行调整的敏感性分析证实了这些发现。
LBP患者的关节活动度过大与女性、年轻、站立位和仰卧位时腰椎前凸增加有关，然而，与背痛增加、前滑脱程度或体位之间更严重的腰椎变化无关。
