非特异性腰痛患者腰骶结构特征及其影响因素

摘要

研究非特异性腰痛(non-specific low back pain,NLBP)患者的腰骶结构特征及其影响因素.方法:招募筛选NLBP患者71例(NLBP组)及29例无腰痛的健康人群(Con组).填写问卷评估疼痛程度和腰功能障碍,并分别拍摄矢状面及额状面的X光片,测定腰椎前凸程度和骨盆侧倾程度的相关指标.研究发现:①NLBP组腰椎前凸程度与Con组相比无显著性差异(P>0.05);②NLBP组与Con组相比骨盆发生明显侧倾(P<0.05);③性别对NLBP患者腰骶结构没有影响;④不同年龄的NLBP患者腰椎结构有发生不同的改变,青年患者与中老年患者相比,腰骶出现了显著的腰曲变直(P<0.05)及骨盆侧倾(P<0.01);⑤症状也会影响NLBP患者的腰椎前凸程度(P<0.05).研究结论:①骨盆侧倾是NLBP患者的共性,可将该指标用于临床诊断和疗效评估;②不同年龄、性别和症状的NLBP患者进行康复时应有针对性.%The purpose of this study was to investigate the lumbo-sacral structure of non-specific low back pain (NLBP)by X-ray, and to analyze the influencial factors.71 NLBP patients (NLBP Group), and 29 health persons without back pain (Con Group) were chosen.The VAS (Visual Analogue Scale), ODI (Oswestry disability index) and X-ray film were used to evaluate the sagittal lumbo-sacral structure and the frontal pelvic position (PI).The results showed that: 1.There was no obvious differences of sagittal lumbo-sacral structure indicators between two groups(P>0.05), but the NLBP group showed a trend of decrease.2.There was obvious differences of frontal pelvic position (PI) between two groups (P<0.05).3.Gender was not related to the lumbo-sacral structure(P>0.05);4.The age influenced the lumbo-sacral structure differently;5.The pain and dysfunction also influenced NLBP (P>0.05).It could be concluded that: 1.NLBP showed obvious lateral tilt of pelvis,the soft tissues of the two sides were apparently imbalance, and PI could be considered as a sensitive indicator for NLBP;2.The age, pain and dysfunction affected the lumbar curvature, these factors should be taken into consideration in diagnosing and making rehabilitation for NLBP.