Impact of joint hypermobility on lumbar positional changes in back pain patients: a cross-sectional weight-bearing MRI study.

Autor: Thorseth I; Department of Rheumatology, The Parker Institute, Copenhagen University Hospital, Bispebjerg and Frederiksberg Hospital, Nordre Fasanvej 57, 2000, Copenhagen, Denmark. thorseth@hotmail.com.; Department of Anesthesiology, Nykøbing Falster Hospital, Nykøbing Falster, Region Zealand, Denmark. thorseth@hotmail.com., Nordberg CL; Department of Rheumatology, The Parker Institute, Copenhagen University Hospital, Bispebjerg and Frederiksberg Hospital, Nordre Fasanvej 57, 2000, Copenhagen, Denmark.; Department of Radiology, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark., Boesen M; Department of Radiology, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark., Bliddal H; Department of Rheumatology, The Parker Institute, Copenhagen University Hospital, Bispebjerg and Frederiksberg Hospital, Nordre Fasanvej 57, 2000, Copenhagen, Denmark., Fournier GL; Department of Rheumatology, Copenhagen University Hospital, Rigshospitalet, Bispebjerg and Frederiksberg, Copenhagen, Denmark., Hansen P; Department of Radiology, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark., Nielsen SM; Department of Rheumatology, The Parker Institute, Copenhagen University Hospital, Bispebjerg and Frederiksberg Hospital, Nordre Fasanvej 57, 2000, Copenhagen, Denmark., Hansen BB; Department of Rheumatology, The Parker Institute, Copenhagen University Hospital, Bispebjerg and Frederiksberg Hospital, Nordre Fasanvej 57, 2000, Copenhagen, Denmark.; Department of Rheumatology, Copenhagen University Hospital, Rigshospitalet, Bispebjerg and Frederiksberg, Copenhagen, Denmark.
Jazyk: angličtina
Zdroj: European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society [Eur Spine J] 2024 Nov 28. Date of Electronic Publication: 2024 Nov 28.
DOI: 10.1007/s00586-024-08577-z
Abstrakt: Purpose: To investigate positional lumbar changes by weight-bearing MRI in low back pain (LBP) patients with hypermobile joints (Beighton score ≥ 4).
Methods: Patients referred to weight-bearing MRI went through a clinical examination, including Beighton's test, answered back pain-related questionnaires, and were hereafter imaged in supine and standing in a 0.25-T MRI unit. All MRI exams were evaluated for degenerative findings i.e., herniations, disc degeneration, spinal stenosis, disc degeneration, and spondylolisthesis. Subsequently, the lumbar lordosis angle, the sacral angle, and all spondylolisthesis' slippages were measured for both positions.
Results: Of 257 LBP patients, Beighton score ≥ 4 were seen in 48 patients, and these included more females (81.3% vs. 51.7%), younger patients (mean difference [MD]: -8.1 years), and had less degenerated lumbar discs (sum-score MD: -0.9). No difference between groups in degenerative MRI findings was found, although, a non-significant tendency (p = 0.072) to a higher number of anterolisthesis in the hypermobile patients. The hypermobile patients had a greater lordosis angle both during supine and standing and a greater sacral angle in supine, however, changes in the angles between supine and standing were without difference between groups. A sensitivity analysis adjusted for gender and age confirmed these findings.
Conclusion: Hypermobility in LBP patients was associated with being female, younger, having increased lumbar lordosis both during standing and in supine, however, was not associated with increased back pain, anterolisthesis grade or more severe lumbar changes between positions.
Competing Interests: Declarations. Conflict of interest: Nothing to disclose.
(© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
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