髋骨对称性失衡与非特异性腰痛相关性的病例对照研究

Association between Hip Symmetry Imbalance and Non-specific Low Back Pain:A Case-control Study

目的结合冠状面及矢状面的影像参数来分析髋骨及骨盆三维空间稳定性稳定性与非特异性腰痛(non-specific low back pain,NSLBP)间的关系。方法研究采用病例对照的方法。采用数字化X线成像系统收集腰痛组(n=33)与健康组(n=66)的骨盆正侧位影像参数,比较两组影像参数差异是否有统计学意义,并在此基础上分析各参数与腰痛间的关系。收集的影像参数包括双侧髋骨闭孔大小(obturator foramen size,OFS)、骨盆旋转角(pelvic rotation angle,PRA)、骶骨倾斜角(sacral slope,SS)、骨盆入射角(pelvic incidence angle,PI)、腰骶关节角(lumbosacral angle,LSA)。OFS、PRA分别反映了双侧髋骨垂直轴、矢状轴的平衡情况,SS反映了骨盆冠状轴位置的平衡情况。结果两组OFS、PRA、SS比较差异均有统计学意义,且OFS、PRA、SS均与NSLBP具有一定相关性。除OFS与SS间具有显著相关性外,其他各参数间并无明显相关性。OFS、PRA、SS三者均异常时提示腰痛发生率明显提高,OFS对NSLBP具有一定诊断价值。结论髋骨对称性失衡可引发骨盆失稳,且与NSLBP的发生具有显著相关性。

Objective To analyze the association between hip and pelvic stability and non-specific low back pain(NSLBP)by comparing the coronal and sagittal imaging parameters.Methods We conducted a case-control study.The digital x-ray system was used to collect the pelvic positive and lateral image parameters from the low back pain group(n=33)and the healthy group(n=66).The imaging parameters between the two groups were compared for statistically significant differences,and the relationship between each parameter and low back pain was analyzed.The two cohorts were compared in parameters including the Obturator foramen size(OFS),Pelvic rotation angle(PRA),sacral slope(SS),Pelvic incidence angle(PI),and lumbosacral angle(LSA).OFS and PRA are the indicators of the balance of the vertical axis and sagittal axis of the bilateral hip bones,respectively.SS associates with the balance of pelvic coronal axis.Results The comparisons in parameters OFS,PRA,and SS showed significant differences between the groups,and they all had correlation with NSLBP to different extent.Except for the significant correlation between OFS and SS,there was no significant correlation between other parameters.Simultaneous abnormalities in OFS,PRA,and SS were associate with increased incidence of low back pain.OFS had certain value for the diagnosis of NSLBP.Conclusion Hip symmetry imbalance can cause pelvic instability.There was a significant correlation between hip symmetry imbalance and NSLBP.