Marchiori D M, Henderson C N
Spine (Phila Pa 1976). 1996 Dec 1;21(23):2747-51. doi: 10.1097/00007632-199612010-00007.
A cross-sectional design was used to correlate cervical radiographic findings of spinal degeneration to neck pain and disability.
The results were correlated to assess the clinical importance of radiographic spinal degeneration.
Past investigations suggest little association between clinical findings and radiographic evidence of spinal degeneration. However, changes in activities of daily living and chronicity of complaint have not been investigated.
Over a 5-month period, data were collected on 700 consecutive patients referred for cervical radiographic examination as part of their clinical evaluation. While in the radiology department, all subjects completed a visual analog pain scale, neck disability index, and short questionnaire, all of which quantified various aspects of any neck complaint. Relationships between indices of patient complaint and the number of cervical degenerative intervertebral discs were evluated using regression analysis.
A significant relationship (P < 0.001) was noted between the number of levels of intervertebral disc degeneration and the chronicity of cervical complaint. No significant relationship was found between cervical degeneration and past trauma (P = 0.904) or gender (P = 0.213). Multiple-regression analysis of visual analog pain scale scores revealed a significant two-way interaction with chronicity and past trauma (P = 0.007) and a significant main effect with gender (P < 0.001). Cervical degeneration was not significant as a main effect or interaction with other factors. Multiple-regression analysis of neck disability index scores demonstrated a significant three-way interaction of chronicity, degeneration, and gender (P = 0.022) and a significant two-way interaction for chronicity and trauma (P = 0.025). No additional information was gathered by multivariate multiple-regression techniques.
Increasing levels of spinal degeneration are related to increasing chronicity of patient complaints. Spinal degeneration is not related to past trauma or gender. Women, but not men, report higher disability with increasing levels of degeneration. Subjects with past trauma reported more intense pain and disability. Overall, men reported less neck pain and disability than women.
采用横断面设计将颈椎退变的影像学表现与颈部疼痛及功能障碍进行关联。
对结果进行关联分析以评估影像学脊柱退变的临床重要性。
既往研究表明临床发现与脊柱退变的影像学证据之间关联甚微。然而，日常生活活动的变化及主诉的慢性化情况尚未得到研究。
在5个月的时间里，收集了700例因颈椎影像学检查作为临床评估一部分而连续转诊患者的数据。在放射科时，所有受试者均完成了视觉模拟疼痛量表、颈部功能障碍指数及简短问卷，所有这些均量化了任何颈部主诉的各个方面。使用回归分析评估患者主诉指标与颈椎退变椎间盘数量之间的关系。
椎间盘退变节段数量与颈部主诉的慢性化之间存在显著关系（P < 0.001）。未发现颈椎退变与既往创伤（P = 0.904）或性别（P = 0.213）之间存在显著关系。视觉模拟疼痛量表评分的多元回归分析显示，与慢性化和既往创伤存在显著的双向交互作用（P = 0.007），与性别存在显著的主效应（P < 0.001）。颈椎退变作为主效应或与其他因素的交互作用不显著。颈部功能障碍指数评分的多元回归分析显示，慢性化、退变和性别之间存在显著的三向交互作用（P = 0.022），慢性化和创伤之间存在显著的双向交互作用（P = 0.025）。多变量多元回归技术未收集到更多信息。
脊柱退变程度增加与患者主诉慢性化程度增加相关。脊柱退变与既往创伤或性别无关。女性而非男性报告随着退变程度增加功能障碍更严重。有既往创伤的受试者报告疼痛和功能障碍更强烈。总体而言，男性报告的颈部疼痛和功能障碍少于女性。
