脊柱侧凸是疼痛的来源吗?

IF 1.3 4区 医学 Q3 ORTHOPEDICS Journal of Childrens Orthopaedics Pub Date : 2023-11-28 eCollection Date: 2023-12-01 DOI:10.1177/18632521231215861
Brice Ilharreborde, Anne-Laure Simon, Milud Shadi, Tomasz Kotwicki
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引用次数: 0

摘要

目的:脊柱侧凸疼痛无疑是一个越来越受欢迎的热门话题。文献仍然非常有争议,疼痛患病率从23%到90%不等,但这可以通过众多系列的巨大异质性来解释。本综述的目的是报道与脊柱侧凸相关的疼痛的文献结果,而不考虑其病因。方法:检索2003 ~ 2023年3月Medline和Google数据库的文献资料。结合作者的经验,对相关文献进行了分析、总结和讨论。我们还纳入了一组为期1年的前瞻性青少年特发性脊柱侧凸患者,以与现有文献进行比较。结果:共纳入126例青少年特发性脊柱侧凸患者,术前Cobb角平均为64.5°(范围45°-112°)。报告的疼痛患病率为34.1%。疼痛组和无疼痛组的自我报告体验差异很大,无疼痛组的平均视觉模拟评分为0.5(±0.6)分,而疼痛组的平均视觉模拟评分为5.6(±1.2)分(p结论:关于“脊柱侧凸是疼痛来源”的循证文献仍不明确。在畸形程度和背部疼痛强度之间缺乏直接关系这一点上,人们似乎达成了共识。因此,在进行任何治疗之前,对患者进行全面的评估是必要的,包括病史、临床检查和脊柱侧凸和背痛患儿的相关影像学检查。证据等级:六级。
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Is scoliosis a source of pain?

Purpose: Pain in scoliosis is definitely a hot topic with growing popularity. The literature remains very controversial, with a pain prevalence ranging from 23% to 90%, but this can be explained by the great heterogeneity of the numerous series. The aim of this review was to report results from the literature regarding pain in relation to scoliosis regardless of the etiology.

Methods: A bibliographic search in Medline and Google database from 2003 to March 2023 was performed. Relevant literature was analyzed, summarized, and discussed based on authors' experience. A 1-year prospective series of adolescent idiopathic scoliosis patients was also included to compare with the existing literature.

Results: A total of 126 adolescent idiopathic scoliosis patients were included, with a mean preoperative Cobb angle of 64.5° (range, 45°-112°). Reported pain prevalence was 34.1%. Pain and no-pain groups were very different in their self-reported experience, with a very low mean visual analogue scale score of 0.5 (± 0.6) in the no pain group, while visual analogue scale averaged 5.6 (± 1.2) in the pain group (p < 0.001). No significant difference was found between groups regarding the most relevant demographic and radiological parameters.

Conclusion: Evidence-based literature on "scoliosis as a source of pain" remains ambiguous. There seems to be a consensus on the lack of direct relationship between deformity magnitude and back pain intensity. A comprehensive evaluation of the patient is therefore necessary before any treatment, including medical history, clinical examination, and relevant imaging for any child with scoliosis and back pain.

Level of evidence: Level VI.

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来源期刊
Journal of Childrens Orthopaedics
Journal of Childrens Orthopaedics Medicine-Orthopedics and Sports Medicine
CiteScore
2.70
自引率
14.30%
发文量
61
审稿时长
23 weeks
期刊介绍: Aims & Scope The Journal of Children’s Orthopaedics is the official journal of the European Paediatric Orthopaedic Society (EPOS) and is published by The British Editorial Society of Bone & Joint Surgery. It provides a forum for the advancement of the knowledge and education in paediatric orthopaedics and traumatology across geographical borders. It advocates an increased worldwide involvement in preventing and treating musculoskeletal diseases in children and adolescents. The journal publishes high quality, peer-reviewed articles that focus on clinical practice, diagnosis and treatment of disorders unique to paediatric orthopaedics, as well as on basic and applied research. It aims to help physicians stay abreast of the latest and ever-changing developments in the field of paediatric orthopaedics and traumatology. The journal welcomes original contributions submitted exclusively for review to the journal. This continuously published online journal is fully open access and will publish one print issue each year to coincide with the EPOS Annual Congress, featuring the meeting’s abstracts.
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