影响60岁以上老年退行性脊柱侧凸发病的相关危险因素

Riskfactors of the onset of degenerative scoliosis in the elderly over 60 years old

目的探讨60岁以上老年患者发生退行性脊柱侧凸的危险因素。方法回顾性收集2015年10与月~2020年10月本院收治的105例因下肢或腰背疼痛、间歇性跛行来院就诊的老年患者临床资料,分析退行性脊柱侧凸的发生率,并采用多因素Logisitic回归分析退行性脊柱侧凸发病的危险因素。结果105例老年患者退行性脊柱侧凸的发生率为23.81%(25/105)。单因素分析显示,退行性脊柱侧凸患者年龄≥70岁、饮酒、骨盆前倾、长短腿、高低肩、扁平足、骨质疏松、胸椎旋转不对称的占比均显著高于非退行性脊柱侧凸患者(P<0.05);多因素Logistic回归分析结果显示,年龄≥70岁、骨盆前倾、长短腿、扁平足、骨质疏松、胸椎旋转不对称是老年患者发生退行性脊柱侧凸的独立危险因素(P<0.05)。建立预测方程,应用ROC曲线求得数学模型诊断的敏感性为92.0%,特异性96.5%。结论60岁以上老年患者发生退行性脊柱侧凸与年龄≥70岁、骨盆前倾、长短腿、扁平足、骨质疏松、胸椎旋转不对称等因素密切相关,构建的预测模型对退行性脊柱侧凸的发生有一定预测价值。

Objective To explore the risk factors of degenerative scoliosis in elderly patients over 60 years old.Methods The clinical data of 105 elderly patients treated in our hospital due to lower extremity or low back pain and intermittent claudication from October 2015 to October 2020 were retrospectively collected.The incidence of degenerative scoliosis was analyzed,and the risk factors of its onset were analyzed by multivariate logistic regression analysis.Results The incidence rate of degenerative scoliosis in the 105 elderly patients was 23.81%(25/105).Univariate analysis showed that the proportions of patients with degenerative scoliosis≥70 years old,drinking,pelvic forward tilt,long and short legs,high and low shoulders,flat feet,osteoporosis and thoracic rotation asymmetry were significantly higher than those with non-degenerative scoliosis(P<0.05).The results of multivariate logistic regression analysis showed that age not younger than 70 years old,pelvic anteversion,leg length discrepancy,flat feet,osteoporosis and thoracic spine rotation asymmetry were independent risk factors of degenerative scoliosis in elderly patients.The predictive equations were established.The diagnostic sensitivity and specificity of mathematical model were 92.0%and 96.5%,respectively.Conclusion The occurrence of degenerative scoliosis in elderly patients over 60 years old is closely related to age not younger than 70 years old,pelvic anteversion,leg length discrepancy,flat feet,osteoporosis and thoracic spine rotation asymmetry.The constructed predictive model is of certain predictive value for the occurrence of degenerative scoliosis.