Lumbosacral Transitional Vertebra-Related Low Back Pain: Resolving the Controversy
Lumbosacral Transitional Vertebra-Related Low Back Pain: Resolving the Controversy
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DOI：
10.4184/asj.2018.12.3.407
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发表时间：
2018-06-01
影响因子：
2.3
通讯作者：
Yerramshetty, Janardhan Srinivas
中科院分区：
文献类型：
--
作者：
Gopalan, Balachandar;Yerramshetty, Janardhan Srinivas
研究设计：病例对照研究目的：腰骶移行椎（LSTV）与腰痛（LBP）的关系存在争议，职业性体力活动和放射性脊柱异常提示其他脊柱疾病（OSD），如脊柱变性和不稳定的作用也存在争议。本研究旨在确定LSTV与LBP是否存在任何关联。如果是这样的话，协会的水平的体力活动和存在的OSD与LSTV相关的LBP determined.Overview的文献：LBP的原因已被链接到近端水平椎间盘退变，关节炎pseudocarcination之间的LSTV和骶骨翼，小关节退变，和神经根压缩由于扩大横突。LSTV与LBP是存在于个人谁是参与高层次的体力活动，包括新兵和athlets.Methods：这是一个不匹配的研究，包括372例和224例对照连续招募临床和影像学文件。结果：LSTV（p=0.039）与LBP显著相关，OSD（p =0.024）与LSTV相关的LBP显著相关。体力活动水平与LBP无关。人口统计学分析显示，在患有LSTV相关LBP的OSD.Conclusions患者中，年龄较大（> 45岁）的女性占优势：LSTV的存在与LBP患病率的增加有关。这种关联可能是由于OSD的混杂效应。职业体力活动水平与LSTV相关LBP无关。我们推测，在我们的研究中，高龄和女性导致了LSTV与LBP的虚假关联，使得LSTV相关的LBP在已发表的文献中存在争议。
Study Design: Case control study.Purpose: The association of lumbosacral transitional vertebra (LSTV) with low back pain (LBP) is controversial, as is the role of occupational physical activity and radiological spinal abnormalities suggestive of other spinal disorders (OSDs) such as spinal degeneration and instability. This study aimed to determine if any association of LSTV with LBP exists. If so, the association of the level of physical activity and presence of OSD with LSTV-related LBP was determined.Overview of Literature: The cause of LBP has been linked to proximal level disc degeneration, arthritic pseudoarticulation between LSTV and the sacral ala, facet joint degeneration, and nerve root compression due to a broadened transverse process. LSTV associated with LBP is present among individuals who are involved in high-level physical activity, including military recruits and athletes.Methods: This was an unmatched study comprising 372 cases and 224 controls consecutively recruited with clinical and radiographic documentation. The relationship between LSTV and LBP was analyzed, and the effects of LSTV and OSD on this relationship were also assessed and statistically controlled.Results: The presence of LSTV (p=0.039) was significantly associated with LBP, and the presence of OSD was associated with LTSV-related LBP, after statistically controlling for the level of physical activity (p=0.024). The level of physical activity was not associated with LBP. Demographic analysis revealed female predominance with an advanced age (> 45 years) among those with LSTV-related LBP who have OSD.Conclusions: The presence of LSTV was associated with an increased prevalence of LBP. This association was probably due to the confounding effect of OSD. The level of occupational physical activity was not associated with LSTV-related LBP. We speculate that advanced age and female sex caused the spurious association of LSTV with LBP in our study, rendering LSTV-related LBP controversial in published literature.