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Abstract：
Osteoporosis, vertebral fractures, and spinal degenerative diseases are common conditions that often coexist in older adults. This study aimed to determine the factors influencing low back pain and its impact on activities of daily living (ADL) and physical performance in older individuals with multiple comorbidities. This cross-sectional study was part of a large-scale population-based cohort study in Japan, involving 1009 participants who underwent spinal magnetic resonance imaging (MRI) to assess cervical cord compression, radiographic lumbar spinal stenosis, and lumbar disc degeneration. Vertebral fractures in the thoracolumbar spine were evaluated using sagittal MRI with a semi-quantitative method. Bone mineral density was measured using dual-energy X-ray absorptiometry. Low back pain, Oswestry Disability Index (ODI), and physical performance tests, such as one-leg standing time, five times chair-stand time, maximum walking speed, and maximum step length, were assessed. Using clinical conditions as objective variables and image evaluation parameters as explanatory variables, multiple regression analysis showed that vertebral fractures were significantly associated with low back pain and ODI. Vertebral fractures and osteoporosis significantly impacted physical performance, whereas osteoporosis alone did not affect low back pain or ODI. Our findings contribute to new insights into low back pain and its impact on ADL and physical performance.
摘要：
骨质疏松,椎骨骨折,脊柱退行性疾病是老年人常共存的常见疾病。这项研究旨在确定影响腰背痛的因素及其对具有多种合并症的老年人的日常生活活动（ADL）和身体表现的影响。这项横断面研究是日本大规模基于人群的队列研究的一部分，涉及1009名接受脊髓磁共振成像（MRI）评估颈脊髓压迫的参与者，影像学腰椎管狭窄症，和腰椎间盘退变。使用矢状位MRI以半定量方法评估胸腰椎的椎体骨折。使用双能X射线吸收法测量骨矿物质密度。腰痛,Oswestry残疾指数（ODI），和物理性能测试，比如单腿站立时间，五次椅子站立时间，最大步行速度,和最大步长，被评估。以临床情况为客观变量,以影像评价参数为解释变量,多元回归分析显示，椎体骨折与腰背痛和ODI显著相关。椎体骨折和骨质疏松显著影响身体表现,而单独的骨质疏松症并不影响下腰痛或ODI。我们的发现有助于对下腰痛及其对ADL和身体表现的影响的新见解。
