摘要
目的:探讨导致中老年腰痛患者退行性腰椎不稳的临床及影像学相关因素。方法:回顾性分析2015年12月至2017年3月本院脊柱外科因腰痛就诊并符合纳入、排除标准的152位患者,根据腰椎稳定与否分为两组:A组,单纯腰椎不稳患者63例;B组,腰椎稳定患者89例。本研究资料中老年腰痛患者退行性腰椎不稳的相关危险因素包括年龄、性别、吸烟史、体质量指数、病程、糖尿病史、腰椎曲度、黄韧带肥厚、Modic改变、间盘退变程度等10项指标。为了使研究结果更加准确,本研究中将年龄、体质量指数、病程、腰椎曲度等连续变量离散为分类变量。患者的性别、吸烟史、糖尿病史、黄韧带肥厚、Modic改变、间盘退变程度作为分类变量。将以上10项因素先采用秩和检验或卡方检验进行单因素方差分析,然后将具有统计学意义的结果作为自变量,以是否出现腰椎不稳作为因变量,进行Logistic回归分析最后确定导致腰椎不稳的危险因素。结果:单因素方差分析显示体质量指数、腰椎曲度、间盘退变程度、黄韧带肥厚、Modic改变等与腰椎不稳的形成相关,而年龄、性别、吸烟史、糖尿病史、病程等与腰椎不稳的形成无关。Logistic回归分析结果显示体质量指数(P=0.025)、腰椎曲度(P=0.004)、间盘退变程度(P=0.001)、黄韧带肥厚(P=0.029)、Modic改变(P=0.003)是腰椎不稳形成的危险因素。结论:1)中老年腰痛患者退行性腰椎不稳受多种因素影响,其中体质量指数、腰椎曲度、间盘退变程度、黄韧带肥厚、Modic改变与腰椎不稳的产生有关,体质量指数增大、腰椎曲度异常、间盘退变严重、黄韧带肥厚、Modic改变是腰椎不稳产生的危险因素。2)中老年腰痛患者中年龄、性别、吸烟史、糖尿病史、病程等因素可能与腰椎不稳产生无关。
Objective：To explore the clinical and imaging factors associated with degenerative lumbar instability in middle-elderly patients with low back pain.Methods：Retrospective analysis 152 patients with low back pain and met the inclusion criteria,who had spinal surgery in our hospital from December 2015 to March 2017.They were divided into A and B group according to the stability of the lumbar spine.Group A with 63 patients with simple lumbar instability,and group B with 89 patients with lumbar stability.In this study,the risk factors of degenerative lumbar instability in elderly patients with low back pain included age,sex,smoking history,body mass index,course of disease,history of diabetes,lumbar curvature,ligamentum flavum hypertrophy,Modic change,and indicators.In order to make the research results more accurate,the continuous variables such as age,body mass index,course of disease,lumbar curvature were discretized as categorical variables.Patient＇s sex,smoking history,diabetes history,ligamentum flavum hypertrophy,Modic change,and disc degeneration as a categorical variable.The above 10 factors were analyzed by single factor analysis using rank sum test or chi square test.Then,statistically significant results were used as independent variables,and the lumbar instability was taken as the dependent variable.Logistic regression analysis was carried out of risk factors for lumbar instability.Results：Analysis of variance showed that the body mass index,lumbar curvature,degree of intervertebral disc degeneration,ligamentum flavum,and Modic change were related to the formation of lumbar instability,while the age,sex,smoking history,history of diabetes,course of disease and lumbar instability was not related to the formation.Logistic regression analysis showed that the body mass index（P=0.025）,lumbar curvature（P=0.004）,disc degeneration（P=0.001）,and ligamentum flavum（P=0.029）was the formation of lumbar instability risk factors.Conclusion：The degenerative lumbar instability in middle-elderly pa
作者
彭兵
程招军
胡炜
袁建军
朱如森
李巍
宋红艳
熊波
张学利
PENG Bing;CHENG Zhaojun;HUWei;YUAN Jianjun;ZHURusen;LI Wei;SONG Hongyan;XIONG Bo;ZHANG Xueli(Liuyang Hospital o{ Traditional Chinese Medieine,Liuyang 410300, Hunan China;Tianjin University of Traditional Chinese Medicine, Tianjin 300193, China;People＇ s Hospital of Tianj in, Tianjin 300191, China.)
出处
《中国中医骨伤科杂志》
CAS
2018年第5期14-18,共5页
Chinese Journal of Traditional Medical Traumatology & Orthopedics
关键词
中老年
腰痛
腰椎不稳
危险因素
middle-elderly patients
low back pain
lumbar instability
risk factors
