Dose-response relationship between spino-pelvic alignment determined by sagittal modifiers and back pain-specific quality of life
Dose-response relationship between spino-pelvic alignment determined by sagittal modifiers and back pain-specific quality of life
复制标题
由矢状调节器确定的脊柱-骨盆排列与背痛特定生活质量之间的剂量-反应关系
DOI：
10.1007/s00586-021-06965-3
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发表时间：
2021
影响因子：
2.8
通讯作者：
Konno Shin-ichi
中科院分区：
文献类型：
--
作者：
Tominaga Ryoji;Kurita Noriaki;Kokubun Yoshiyuki;Nikaido Takuya;Sekiguchi Miho;Otani Koji;Iwabuchi Masumi;Shirado Osamu;Fukuhara Shunichi;Konno Shin-ichi
目的为了确定脊柱侧凸学会(SRS)-Schwab分类中矢状面调节因子（SMs）的异常是否真正反映了背痛（BP）特异性生活质量（QOL），有必要研究它们的剂量-反应关系，并确定BP特异性生活质量下降的临床影响阈值。本研究旨在分析每种SM与bp特异性生活质量之间的连续剂量-反应关系。方法本横断面研究采用日本人口队列研究的数据，纳入519名年龄≥50岁的社区居民，这些居民参加了年度健康检查。参与者完成了罗兰-莫里斯残疾问卷（RDQ）的bp特异性生活质量。通过全脊柱x线检查评估基于SMs的脊柱-骨盆对准。我们拟合了具有或不具有非线性项的一般线性模型，以估计每种SM与bp特异性QOL之间的剂量-响应关系。结果骨盆倾斜、骨盆发生率减去腰椎前凸（PI-LL）和矢状垂直轴与bp特异性生活质量呈剂量-反应关系，以RDQ评分衡量。当PI-LL值超过第90百分位时，它最有可能预测具有最低临床重要性的RDQ评分。PI-LL与bp特异性生活质量评分呈非线性关系。当PI-LL超过10°时，RDQ增加。结论在SRS-Schwab分类中，pi - ll可能是确定bp特异性生活质量最敏感的修饰因子。此外，当针对失调的补偿机制超过临界值时，bp特异性生活质量迅速恶化。因此，我们建议应重新检查传统的分类和手术策略，以制定更可靠的分类策略。
PurposeTo determine whether abnormalities of the sagittal modifiers (SMs) of the Scoliosis Research Society (SRS)-Schwab classification truly reflect back pain (BP)-specific quality of life (QOL), it is necessary to examine their dose–response relationships and to determine clinically impactful thresholds for declines in BP-specific QOL. This study aimed to analyse the continuous dose–response relationship between each SM and BP-specific QOL.MethodsThis cross-sectional study, using data from a Japanese population-based cohort study, included 519 community-dwelling residents aged ≥ 50 years who participated in the annual health examination. The participants completed the Roland–Morris Disability Questionnaire (RDQ) on BP-specific QOL. Spino-pelvic alignment based on SMs was assessed by whole-spine X-ray examinations. We fitted general linear models with or without nonlinear terms to estimate the dose–response relationship between each SM and BP-specific QOL.ResultsPelvic tilt, pelvic incidence minus lumbar lordosis (PI-LL), and sagittal vertical axis showed dose–response relationships with BP-specific QOL measured as the RDQ score. PI-LL was most likely to predict a minimally clinically important RDQ score when its value exceeded the 90th percentile. A nonlinear relationship between PI-LL and the BP-specific QOL score was found. RDQ increased when PI-LL exceeded 10°.ConclusionPI-LL might be the most sensitive of the three modifiers of the SRS-Schwab classification for determining BP-specific QOL. Moreover, BP-specific QOL worsens rapidly when the compensatory mechanism against malalignment exceeds a critical value. Therefore, we suggest that traditional classifications and surgical strategies should be re-examined regarding the dose-dependent abnormalities of the SMs to develop a more reliable classification strategy.
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影响因子：
3
作者：
Hallager, Dennis Winge;Hansen, Lars Valentin;Dahl, Benny
通讯作者：
Dahl, Benny
DOI：
10.1201/9781315154053-36
发表时间：
2018-07
期刊：
50 Landmark Papers
影响因子：
--
作者：
M. Bond;T. Ailon
通讯作者：
M. Bond;T. Ailon
影响因子：
5.3
作者：
Yilgor, Caglar;Sogunmez, Nuray;Alanay, Ahmet
通讯作者：
Alanay, Ahmet
影响因子：
2.8
作者：
Kumar, MN;Baklanov, A;Chopin, D
通讯作者：
Chopin, D
影响因子：
4
作者：
Miyakoshi, N.;Hongo, M.;Shimada, Y.
通讯作者：
Shimada, Y.