Lumbar spondylosis

腰椎病
  • 文章类型: Journal Article
    腰椎病,以腰椎退行性变化为特征,经常导致疼痛,脊柱稳定性降低,肌肉骨骼功能障碍.了解腰椎病对肌肉骨骼功能的影响,尤其是腰椎伸肌耐力,功能平衡,和稳定性的极限,对于改善受影响个人的管理和福祉至关重要。这项研究旨在评估腰椎伸肌耐力,功能平衡,与年龄匹配的健康个体相比,腰椎病患者的稳定性极限,并探索腰椎病患者组中这些参数之间的相关性。腰椎病组由60名最初由骨科医生筛查并接受物理治疗的个体组成。招募年龄匹配的健康对照(n=60)。纳入标准包括两组45-70岁的成年人。使用Sorensen测试评估腰椎伸肌耐力,使用Berg平衡量表进行功能平衡,以及使用计算机化稳定力平台的稳定性极限。与健康对照组相比,腰椎颈椎病患者的腰椎伸肌耐力显着降低(23.06svs.52.45s,p<0.001)。功能平衡,根据伯格平衡量表的评估,在腰椎病组中表现出明显的下降(48.36vs.53.34,p<0.001)。此外,稳定性变量的极限,在睁眼和闭眼的情况下,腰椎病组表现出明显的损伤(所有变量p<0.001)。在腰椎病组内,腰椎伸肌耐力与功能平衡呈显着正相关(0.46,p<0.001),与稳定性变量的极限呈负相关(所有变量的r范围为-0.38至-0.49,p<0.01)。这项研究强调了解决腰椎伸肌耐力的重要性,功能平衡,腰椎综合治疗中的稳定性障碍。
    Lumbar spondylosis, characterized by degenerative changes in the lumbar spine, often leads to pain, reduced spinal stability, and musculoskeletal dysfunction. Understanding the impact of lumbar spondylosis on musculoskeletal function, particularly lumbar extensor endurance, functional balance, and limits of stability, is crucial for improving the management and well-being of affected individuals. This study aimed to assess lumbar extensor endurance, functional balance, and limits of stability in individuals with lumbar spondylosis compared to age-matched healthy individuals and explore the correlations among these parameters within the lumbar spondylosis group. The lumbar spondylosis group consisted of 60 individuals initially screened by an orthopedician and referred to physical therapy. Age-matched healthy controls (n = 60) were recruited. Inclusion criteria encompassed adults aged 45-70 years for both groups. Lumbar extensor endurance was assessed using the Sorensen test, functional balance with the Berg Balance Scale, and limits of stability using a computerized stabilometric force platform. Lumbar extensor endurance was significantly lower in individuals with lumbar spondylosis compared to healthy controls (23.06 s vs. 52.45 s, p < 0.001). Functional balance, as assessed by the Berg Balance Scale, demonstrated a significant decrement in the lumbar spondylosis group (48.36 vs. 53.34, p < 0.001). Additionally, limits of stability variables, under both eyes-open and eyes-closed conditions, exhibited marked impairments in the lumbar spondylosis group (p < 0.001 for all variables). Within the lumbar spondylosis group, lumbar extensor endurance exhibited significant positive correlations with functional balance (0.46, p < 0.001) and negative correlations with limits of stability variables (r ranging from -0.38 to -0.49, p < 0.01 for all variables). This study underscores the significance of addressing lumbar extensor endurance, functional balance, and stability impairments in the comprehensive management of lumbar spondylosis.
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    文章类型: Journal Article
    背景:硬膜外类固醇注射(ESI)涉及将类固醇和局部麻醉药注入脊髓硬膜外腔,它们是通过在黄韧带和硬脑膜之间插入针来进行的。此手术适用于继发于椎间盘突出或术后神经根疼痛的腰骶神经根病患者。镇痛药物的缓解期可能会延长>6周,导致非手术治疗成为一个合适的选择。然而,已经报道了ESI对骨矿物质密度的负面影响。
    目的:我们旨在通过分析全国人群数据库来阐明ESI与骨质疏松症风险之间的关联。
    方法:本研究是一项全国性的回顾性队列研究。
    方法:收集了从国家健康保险研究数据库(NHIRD)的2000年受益人注册中随机选择的100万例病例的数据。
    方法:总共,从NHIRD中确定了4,957名在2000年至2013年之间被诊断为腰椎疾病并接受ESI的患者。随后,另外4957例腰椎病患者从相同的数据库中随机选择,并按年龄匹配频率,性别,以及接受ESI的患者的指数年份。
    结果:患者的平均年龄为50.3±17.1岁。ESI和非ESI组的骨质疏松症发生率分别为7.95和7.01/1000人年,分别。ESI队列中骨质疏松风险显著高于非ESI队列(绝对标准化风险比=1.23,95%置信区间=1.05-1.45,P=0.01)。骨质疏松的危险因素为高龄,作为女性,正在经历ESI。ESI队列中的骨质疏松风险显著高于非ESI队列中的男性,最低城市化水平(第四水平),其他职业,和无合并症的亚组。
    结论:NHIRD没有提供骨质疏松症相关量表的信息,肾功能,血压,吸烟习惯,肺功能,日常活动,注射类固醇的剂量。
    结论:对于被诊断为腰椎病的患者,ESI与高骨质疏松症风险相关。因此,这种疗法应该谨慎推荐,特别是对于具有相关危险因素的患者(例如,骨质疏松性骨折的高风险,社会经济地位低下,和退休或失业状态)。
    Epidural steroid injections (ESIs) involve the administration of steroids and local anesthetics into the spinal epidural space, and they are performed by inserting a needle between the ligamentum flavum and dura. This procedure is suitable for patients with lumbosacral radiculopathy secondary to disc herniation or postsurgical radicular pain. The relief period of the analgesic medications may be prolonged by > 6 weeks, resulting in nonsurgical management becoming a suitable option. However, the negative effect of ESIs on bone mineral density has been reported.
    We aimed to clarify the association between ESIs and osteoporosis risk by analyzing a nationwide population database.
    This study is a nationwide retrospective cohort study.
    Data on 1 million cases randomly selected from the 2000 Registry for Beneficiaries of the National Health Insurance Research Database (NHIRD) were collected.
    In total, 4,957 patients who were diagnosed with lumbar spondylosis and received ESIs between 2000 and 2013 were identified from the NHIRD. Subsequently, another 4,957 patients with lumbar spondylosis were randomly selected from the same database and frequency matched by age, gender, and index year with the patients who received ESIs.
    The mean age of the patients were 50.3 ± 17.1 years. The incident rates of osteoporosis in the ESI and non-ESI groups were 7.95 and 7.01 per 1,000 person-years, respectively. Osteoporosis risk was significantly higher in the ESI cohort than in the non-ESI cohort (absolute standardized hazard ratio = 1.23, 95% confidence interval = 1.05-1.45, P = 0.01). The risk factors for osteoporosis were old age, being female, and undergoing ESIs. Osteoporosis risk was significantly higher in the ESI cohort than in the non-ESI cohort in the male, lowest-urbanization-level (fourth level), other-occupations, and comorbidity-free subgroups.
    The NHIRD did not provide information on osteoporosis-related scales, renal function, blood pressure, smoking habit, pulmonary function, daily activities, and dosage of injected steroids.
    For patients diagnosed with lumbar spondylosis, ESIs are associated with a high osteoporosis risk. Thus, this therapy should be recommended with caution, especially for patients with correlated risk factors (e.g., high risk of osteoporotic fracture, low socioeconomic status, and retired or unemployed status).
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  • 文章类型: Journal Article
    Purpose: Reduced proprioception affects fall risks in elderly people with lumbar spondylosis. The decrease in proprioception in the trunk or lower legs may contribute to a decline in postural stability. We aimed to investigate the association between proprioceptive postural stability and fall risks in elderly individuals with lumbar spondylosis.Materials and Methods: In this retrospective study, the centre-of-pressure displacement was determined in elderly individuals with lumbar spondylosis during upright stance while standing on a Wii Balance Board with their eyes closed (fall-risk group, n = 55; non-fall-risk group, n = 60). Vibratory stimulations at 30 Hz were applied to the lumbar multifidus and gastrocnemius to evaluate the relative contributions of proprioceptive signals used in postural control (relative proprioceptive weighting ratio).Results: Compared with the non-fall-risk group, the fall-risk group displayed a high relative proprioceptive weighting ratio (p = 0.024). Relative proprioceptive weighting ratio (odds ratio, 1.1; 95% confidence interval: 1.004-1.109) was independently associated with fall risks after adjusting for confounding factors. Among variables related to fall risk, the relative proprioceptive weighting ratio was a significant factor (p < 0.035).Conclusion: The fall-risk group of elderly individuals with lumbar spondylosis was dependent on the ankle strategy. The fall risk in elderly people with lumbar spondylosis could be due to over-dependence on the input from muscle spindles in the gastrocnemius.
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  • 文章类型: Journal Article
    目的:本研究旨在评估肌肉骨骼疾病(膝骨关节炎[KOA],腰椎病[LS],骨质疏松症[OP])和代谢综合征成分(肥胖[OB],高血压[HT],血脂异常[DL],糖耐量受损[IGT])。
    方法:在1,690名参与者中(596名男性,1,094名妇女)在基线时,1,384人(81.9%;466名男性,918名妇女)在2008年的第一次随访中获得了完整的数据。Logistic回归分析包括肌肉骨骼疾病或代谢成分的发生或不发生作为结果变量,基线时剩余的肌肉骨骼疾病和代谢成分作为解释变量。根据年龄调整,性别,住宅区,吸烟,和酒精消费。
    结果:发生KOA的风险随着HT而显著增加(比值比[OR],2.57;95%置信区间[CI],1.22-5.42;p=0.013)和IGT(OR,1.99;95CI,1.07-3.70;p=0.029)。腰椎发生OP的风险随着股骨颈的OP而增加(OR,4.21;95CI1.46-12.1;p=0.008),反之亦然(或,2.19;95CI,1.01-479;p=0.047)。KOA增加了HT的风险(Kellgren-Lawrence[KL]等级=0,1与KL=2:OR,1.84;95CI,1.09-3.12;p=0.024)和DL(KL=0,1vs.KL≥3:或,1.66;95CI,1.05-2.61;p=0.029)发生。代谢成分的存在与其他代谢成分的发生之间存在相互关系。
    结论:肌肉骨骼疾病的发生和存在之间存在相互关系,特别是KOA,和代谢综合征成分。
    OBJECTIVE: This study aimed to assess the mutual associations between musculoskeletal diseases (knee osteoarthritis [KOA], lumbar spondylosis [LS], osteoporosis [OP]) and metabolic syndrome components (obesity [OB], hypertension [HT], dyslipidemia [DL], impaired glucose tolerance [IGT]).
    METHODS: Of the 1,690 participants (596 men, 1,094 women) at baseline, 1,384 individuals (81.9%; 466 men, 918 women) had complete data at the first follow-up in 2008. Logistic regression analysis included the occurrence or nonoccurrence of the musculoskeletal diseases or metabolic components as the outcome variable and the remaining musculoskeletal diseases and metabolic components at baseline as explanatory variables, adjusted for age, sex, residential region, smoking, and alcohol consumption.
    RESULTS: The risk of KOA occurring increased significantly with HT (odds ratio [OR], 2.57; 95% confidence interval [CI], 1.22-5.42; p = 0.013) and IGT (OR, 1.99; 95%CI, 1.07-3.70; p = 0.029). The risk of OP occurring at the lumbar spine increased with OP at the femoral neck (OR, 4.21; 95%CI 1.46-12.1; p = 0.008), and vice versa (OR, 2.19; 95%CI, 1.01-479; p = 0.047). KOA increased the risk of HT (Kellgren-Lawrence [KL] grade = 0, 1 vs. KL = 2: OR, 1.84; 95%CI, 1.09-3.12; p = 0.024) and DL (KL = 0, 1 vs. KL ≥ 3: OR, 1.66; 95%CI, 1.05-2.61; p = 0.029) occurring. Reciprocal relationships existed between the presence of metabolic components and the occurrence of the other metabolic components.
    CONCLUSIONS: Mutual relationships existed between the occurrence and presence of musculoskeletal diseases, particularly KOA, and metabolic syndrome components.
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