骨质疏松患者的脊柱畸形及其与腰背痛的关系

为分析骨质疏松患者的脊柱畸形与腰前疼痛症状的关系。本文统计了２２１名老年性骨质疏松症患者的脊柱外观化、请柬菜程度、椎体骨折类型及其与腰背痛程度的关系。结果：腰背痛的程度和频率有程度有关。椎体呈楔状变形的患者其痛痛程度更为严重其差异具有显著统计学意义（Ｐ〈０．０５）。结论：骨质疏松患者的脊柱畸莆主要表现为脊柱的局部后凸尤其是胸段脊柱后凸角的增大，其中又以凹圆背畸形最为多见。柱畸形明显者其腰背疼前也更     

高原地区卡车驾驶员的腰痛状况调查

目的：对高原地区卡车驾驶员腰痛的状况进行调查。方法：本研究通过发放腰痛调查表和帝地考察的方式,对６６９名在青藏高原实际驾龄在３年以上的载重卡车驾驶员腰痛的状况进行了调查。本组调查对象平均年龄２７．０７岁。结果：（１）高原 地区卡车驾驶员腰痛患病率为９５．０７％,明显腰痛者占６７．１２％。（２）高原地区卡车驾驶员腰痛发病时的平均驾龄为２．５－３．０２７年。（３）高原地区卡车驾驶员腰痛程度随开车年限增     

经椎旁肌间隙入路治疗胸腰椎骨折的临床意义

目的探讨胸腰椎骨折切开复位内固定术中经椎旁肌间隙入路的临床疗效,并与传统后正中入路疗效进行比较。方法将78例切开复位内固定治疗的胸腰椎（T11～L2）骨折患者随机分为观察组和对照组,观察组与对照组分别经椎旁肌间隙入路与后正中入路,比较2组患者围手术期指标如手术时间、术中出血量等,影像学指标及随访期间腰背痛VAS评分、磁共振多裂肌面积等。结果术中出血量、术后引流量及住院日在观察组明显少于对照组,差异有统计学意义（P〈0.05）;观察组术后腰背痛VAS评分方面明显优于对照组（P〈0.05）,而术前术后2组患者在Cobb角、椎体高度、椎间隙高度等方面差异无统计学意义（P〉0.05）;观察组患者术前与术后多裂肌MRI横断位面积差异无统计学意义（P〉0.05）,而对照组术后较术前明显减少（P〈0.05）。结论经椎旁肌间隙入路治疗胸腰椎骨折可避免广泛剥离椎旁肌,进而保护了椎旁肌,减轻了术后腰背痛程度。     

Correlation between baropodometric variables,disability, and intensity of low back pain in pregnant women in the third trimester

BackgroundGrowth of uterus, enlargement of breasts and weight gain result from the development and growth of the fetus during pregnancy. The posture and the displacement of the center of gravity change.ObjectiveCorrelate baropodometric variables with low back pain in pregnant women in the third trimester of pregnancy.MethodsThis is a cross-sectional analytical study conducted in São Luís (MA, Brazil). For data collection, we used a form containing sociodemographic and clinical data, Oswestry Disability Questionnaire for disability evaluation of the lumbar spine, Numerical Rating Scale to measure pain intensity, and baropodometric evaluation.ResultsTwenty-five pregnant women took part in the study. There was a significant and positive correlation (r = 0.404, p = 0.045) between functional disability and hindfoot pressure and a significant and negative correlation (r = −0.404, p = 0.045) between functional disability and plantar pressure in the forefoot of the right foot. In addition, there was a positive and significant correlation between the intensity of pain and the contact area on the left (r = 0.504, p = 0.010) and right (r = 0.509, p = 0.009) foot.ConclusionThere is a relation between disability and plantar pressure and between pain intensity and area of contact of feet in pregnant women.     

The frequency, trajectories and predictors of adolescent recurrent pain: a population-based approach

Recurrent pains are a complex set of conditions that cause great discomfort and impairment in children and adults. The objectives of this study were to (a) describe the frequency of headache, stomachache, and backache in a representative Canadian adolescent sample and (b) determine whether a set of psychosocial factors, including background factors (i.e., sex, pubertal status, parent chronic pain), external events (i.e., injury, illness/hospitalization, stressful-life events), and emotional factors (i.e., anxiety/depression, self-esteem) were predictive of these types of recurrent pain. Statistics Canada’s National Longitudinal Survey of Children and Youth was used to assess a cohort of 2488 10- to 11-year-old adolescents up to five times, every 2 years. Results showed that, across 12–19 years of age, weekly or more frequent rates ranged from 26.1%–31.8% for headache, 13.5–22.2% for stomachache, and 17.6–25.8% for backache. Chi-square tests indicated that girls had higher rates of pain than boys for all types of pain, at all time points. Structural equation modeling using latent growth curves showed that sex and anxiety/depression at age 10–11 years was predictive of the start- and end-point intercepts (i.e., trajectories that indicated high levels of pain across time) and/or slopes (i.e., trajectories of pain that increased over time) for all three types of pain. Although there were also other factors that predicted only certain pain types or certain trajectory types, overall the results of this study suggest that adolescent recurrent pain is very common and that psychosocial factors can predict trajectories of recurrent pain over time across adolescence.     

Exercise for the Primary, Secondary and Tertiary Prevention of Low Back Pain in the Workplace: A Systematic Review

Introduction Low back pain (LBP) is one of the most costly conditions to manage in occupational health. Individuals with chronic or recurring LBP experience difficulties returning to work due to disability. Given the personal and financial cost of LBP, there is a need for effective interventions aimed at preventing LBP in the workplace. The aim of this systematic review was to examine the effectiveness of exercises in decreasing LBP incidence, LBP intensity and the impact of LBP and disability. Methods A comprehensive literature search of controlled trials published between 1978 and 2007 was conducted and a total of 15 studies were subsequently reviewed and analyzed. Results There was strong evidence that exercise was effective in reducing the severity and activity interference from LBP. However, due to the poor methodological quality of studies and conflicting results, there was only limited evidence supporting the use of exercise to prevent LBP episodes in the workplace. Other methodological limitations such as differing combinations of exercise, study populations, participant presentation, workloads and outcome measures; levels of exercise adherence and a lack of reporting on effect sizes, adverse effects, and types of sub-groups, make it difficult to draw definitive conclusions on the efficacy of workplace exercise in preventing LBP. Conclusions Only two out of the 15 studies reviewed were high in methodological quality and showed significant reductions in LBP intensity with exercise. Future research is needed to clarify which exercises are effective and the dose-response relationships regarding exercise and outcomes.     

Treatment of third lumbar transverse process syndrome with point injection plus Tuina

取阿是穴注射复方丹参注射液、维生素B1和维生素B12,配合推拿和功能锻炼治疗第3腰椎横突综合征患者48例,痊愈22例,显效16例,有效10例,总有效率100%.     

Effect of Avicatonin (Chicken Carbocalcitonin) on Galvanic Skin Response: A Randomized, Prospective, Double-Blind, Controlled Study for an Objective Assessment of Pain

In an attempt to objectively evaluate the analgesic effect of avicatonin (chicken carbocalcitonin), galvanic skin response (GSR) was recorded in 18 patients with osteoporosis or osteopenia and backache in a randomized, prospective, double-blind, controlled study. Backache on examination and in daily living was assessed weekly by scores utilizing a questionnaire. After two measurements 1 week apart on induction of backache with a maximum anterior flexion of the back from a supine position, either 20 units of avicatonin or inactive placebo was intramuscularly injected once a week for 4 consecutive weeks. In the avicatonin group but not in the placebo group, the area under the curve (AUC) of GSR tracing was decreased, giving a significant difference between the avicatonin and placebo groups after the second week. The pain score obtained by questionnaire decreased in both groups, suggesting a placebo effect. Galvanic skin response may provide a breakthrough to the objective and reliable evaluation of the biological response to pain which could not be accomplished by questionnaires based on subjective impression markedly influenced by emotional and psychological factors. Received: 3 March 1999 / Accepted: 30 September 1999