脊柱矢状面参数与脊柱疾病多部位疼痛的关联分析

Analysis of the Association between Sagittal Spinal Parameters and Multi-Site Pain in Spinal Disorders

摘要: 目的：探讨脊柱矢状面参数与脊柱疾病患者多部位疼痛分布的关联及独立影响因素。方法：回顾性纳入417例脊柱疾病患者，分为单一部位痛组(n = 64)、双部位痛组(n = 43)、多部位痛组(n = 310)。比较各组人口学、临床特征及脊柱矢状面参数，通过相关性分析、多项Logistic回归及ROC曲线评估参数与疼痛的关联及预测价值。结果：多部位痛组上下肢麻木发生率显著高于其他两组(均P < 0.001)。双部位痛组C2~C7 Cobb角、T1倾斜角显著升高，C2~C7 SVA显著降低(均P < 0.05)。C2~C7 SVA是双部位疼痛的独立影响因素(OR = 0.905, P = 0.006)。单一脊柱参数预测多部位疼痛的AUC均<0.6。结论：脊柱矢状面参数与疼痛分布密切相关，C2~C7 SVA是双部位疼痛的关键影响因素，单一参数无法有效预测多部位疼痛，需结合多维度指标综合评估。

Abstract: Objective: To explore the correlation between sagittal spinal parameters and multisite pain distribution in patients with spinal diseases, and identify independent influencing factors. Methods: A total of 417 patients with spinal diseases were retrospectively enrolled, divided into single-site pain group (n = 64), double-site pain group (n = 43), and multisite pain group (n = 310). Demographic, clinical characteristics and sagittal spinal parameters were compared among groups. Correlation analysis, multinomial Logistic regression and ROC curve were used to evaluate the association and predictive value of parameters with pain. Results: The incidence of upper and lower limb numbness in the multisite pain group was significantly higher than that in the other two groups (all P < 0.001). The C2~C7 Cobb angle and T1 slope in the double-site pain group were significantly increased, while C2~C7 SVA was significantly decreased (all P < 0.05). C2~C7 SVA was an independent influencing factor for double-site pain (OR = 0.905, P = 0.006). The AUC of single spinal parameter for predicting multisite pain was all <0.6. Conclusion: Sagittal spinal parameters are closely related to pain distribution. C2~C7 SVA is a key influencing factor for double-site pain. A single parameter cannot effectively predict multisite pain, and comprehensive evaluation with multi-dimensional indicators is required.