Ryan P J, Blake G, Herd R, Fogelman I
Department of Rheumatology, Guy's Hospital, London, United Kingdom.
Bone. 1994 Jan-Feb;15(1):27-30. doi: 10.1016/8756-3282(94)90887-7.
This study investigated the pain and disability experienced by 85 consecutive postmenopausal Caucasian women, average age 64 years (range 50-82), with spinal osteoporosis, referred to a specialist bone clinic. Symptoms were related to the numbers and severity of vertebral deformities, and degree of kyphosis. Persistent back pain was experienced by 54 (63%) in the lumbar spine and 53 (62%) in the thoracic spine. The severity of thoracic but not lumbar back pain was significantly related by Kendall rank correlation to degree of kyphosis (R = 0.255, p < 0.01), numbers of collapsed vertebrae (R = 0.279, p < 0.01) and a summed score of the severity of collapse for all vertebrae (R = 0.253, p < 0.01). The severity and duration of thoracic back pain was also significantly related to numbers of collapsed vertebrae from T4-T8 alone. Sleep was disturbed in 60%, difficulty obtaining suitable clothes was found in 42% and difficulties with functional activities in 47%, although these were severe in only 10%. Significant associations were also found between scores of osteoporosis severity and sleep disturbance, difficulties with clothes and many functional activities. We conclude that in patients with spinal osteoporosis coming to medical attention, assessment and management of pain, disability, sleep pattern and difficulties with obtaining clothes are required for optimal care.
本研究调查了85名连续就诊于一家专业骨病诊所的绝经后白种女性的疼痛和功能障碍情况，这些女性平均年龄64岁（范围50 - 82岁），患有脊柱骨质疏松症。症状与椎体畸形的数量和严重程度以及脊柱后凸程度相关。54名（63%）女性有持续性下背痛，53名（62%）有胸段脊柱疼痛。肯德尔等级相关性分析显示，胸段而非腰段背痛的严重程度与脊柱后凸程度（R = 0.255，p < 0.01）、椎体压缩数量（R = 0.279，p < 0.01）以及所有椎体压缩严重程度的总分（R = 0.253，p < 0.01）显著相关。胸段背痛的严重程度和持续时间也与仅T4 - T8节段椎体压缩数量显著相关。60%的患者睡眠受到干扰，42%的患者难以找到合适的衣服，47%的患者存在功能活动困难，不过只有10%的患者这些情况较为严重。骨质疏松严重程度评分与睡眠障碍、穿衣困难以及许多功能活动困难之间也存在显著关联。我们得出结论，对于前来就医的脊柱骨质疏松症患者，为了提供最佳治疗，需要对疼痛、功能障碍、睡眠模式以及穿衣困难进行评估和管理。
