Japanese

Title	腰部脊柱管狭窄症における腰痛関連因子の解析
Subtitle	原著 第49回日本脊椎脊髄病学会優秀論文
Authors	黄金勲矢1, 高島弘幸1,2, 寺島嘉紀1, 吉本三徳1, 竹林庸雄3, 山下敏彦1
Authors (kana)
Organization	1札幌医科大学医学部整形外科学講座, 2札幌医科大学附属病院放射線部, 3札幌円山整形外科病院
Journal	Journal of Spine Research
Volume	13
Number	5
Page	770-777
Year/Month	2022 /
Article	原著
Publisher	日本脊椎脊髄病学会
Abstract	「要旨」はじめに: 目的は腰部脊柱管狭窄症における腰痛と関連する因子を解析することである. 対象と方法: 対象は腰部脊柱管狭窄症の患者120例(男性52例, 女性68例, 平均年齢64.1歳)で腰痛visual analogue scale(VAS)が30mmより大きいH群, 30mm以下のL群に分類した. 神経障害型式, VAS(下肢痛, 下肢しびれ), 骨密度, すべり, 脊柱・骨盤アライメント, 椎間板変性, 多裂筋断面積と脂肪浸潤, Modic change, 椎間関節変性を解析した. 結果: H群とL群の平均はそれぞれ, 下肢痛VASが73.3mmと50.3mm, 下肢しびれVASが76.2mmと51.2mm, 腰椎前弯角(lumbar lordosis: LL)が32.6°, 40.4°, sagittal vertical axis(SVA)が54.4mm, 29.2mm, 仙骨傾斜が27.7°, 32.3°, pelvic incidence(PI)-LLが15.9°, 9.6°で有意差を認めた. 多重ロジスティック回帰分析でSVA(調整オッズ比: 1.017, 95%信頼区間: 1.003〜1.031, p<0.05)とPI-LL(調整オッズ比: 1.058, 95%信頼区間: 1.012〜1.152, p<0.05)が有意となった. 結語: 腰部脊柱管狭窄症における腰痛にSVAとPI-LLが有意に関連していた.
Practice	臨床医学：外科系
Keywords	腰部脊柱管狭窄症, 腰痛, 脊柱・骨盤アライメント, lumbar spinal stenosis, low back pain, spinopelvic alignment

English

Title	Analysis of Factors Related to Low Back Pain in Lumbar Spinal Stenosis
Subtitle	Original Article
Authors	Izaya Ogon1, Hiroyuki Takashima1,2, Yoshinori Terashima1, Mitsunori Yoshimoto1, Tsuneo Takebayashi3, Toshihiko Yamashita1
Authors (kana)
Organization	1Department of Orthopaedic Surgery, Sapporo Medical University School of Medicine, 2Division of Radiology and Nuclear Medicine, Sapporo Medical University Hospital, 3Sapporo Maruyama Orthopedic Hospital
Journal	Journal of Spine Research
Volume	13
Number	5
Page	770-777
Year/Month	2022 /
Article	Original article
Publisher	The Japanese Society for Spine Surgery and Related Research
Abstract	[Abstract] Introduction: The purpose of this study was to analyze the factors associated with low back pain (LBP) in patients with lumbar spinal stenosis (LSS). Methods: In total, 120 patients with LSS (52 males and 68 females; mean age, 64.1 +- 1.8 years) participated in this study. LBP was defined as pain on the posterior aspect of the trunk between the 12th rib and the lower end of the glenoid groove that lasts for > 3 months. The patients were classified into two groups: high (H) group, which had a LBP visual analog scale (VAS) score > 30 mm, and the low (L) group, which had a LBP VAS score <- 30 mm. The age, gender, body mass index, neurological disorder pattern, bone mineral density, slippage, spinopelvic alignment, disc degeneration, cross sectional area and fatty infiltration of the multifidus muscle, Modic changes, and facet degeneration were compared between the H and L groups. Multiple logistic regression analysis was performed with group H and L as dependent variables. Results: In the H and L groups, the mean lower leg pain VAS was 73.3 +- 4.6 mm and 50.3 +- 3.5 mm (p < 0.01), the mean lower leg numbness VAS was 76.2 +- 4.9 mm and 51.2 +- 4.1 mm (p < 0.01), the mean lumbar lordosis (LL) was 32.6 +- 3.0° and 40.4 +- 3.1° (p < 0.01), the mean sagittal vertical axis (SVA) was 54.4 +- 6.6 mm and 29.2 +- 6.2 mm (p < 0.01), the mean sacral slope was 27.7° +- 1.3° and 32.3° +- 1.4° (p < 0.05), and the mean pelvic incidence (PI)-LL was 15.9° +- 0.8° and 9.6° +- 0.7° (p < 0.01), respectively. A multiple logistic regression analysis showed that SVA (OR, 1.017; 95% CI: 1.003 - 1.031, p < 0.05) and PI-LL (OR, 1.058; 95% CI: 1.012 - 1.152, p < 0.05) were significantly associated with LBP. Conclusions: SVA and PI-LL were considered to be associated with LBP in patients with LSS.
Practice	Clinical surgery
Keywords	lumbar spinal stenosis, low back pain, spinopelvic alignment

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