【摘要】 目的探讨骨质疏松性椎体骨折部位与疼痛部位之间的一致性关系。方法分析128例骨质疏松性椎体骨折(T8～L4)的临床和X线资料。记录外伤史、骨折部位,采用疼痛视觉模拟评分(VAS)评估初诊时疼痛程度,Kuorinka法标注疼痛部位,Kappa系数检验骨折部位与疼痛部位的一致性。结果各组在性别、年龄、外伤史方面差异无统计学意义(P>0.05)。胸椎骨折VAS评分较腰椎骨折高,差异有统计学意义(P<0.001)。58例胸椎骨折仅15例主诉上背痛,骨折部位与疼痛部位之间一致性较差(Kappa值=0.031,P=0.290);47例中45例腰椎骨折主诉下背部痛,骨折部位与疼痛部位之间一致性较好(Kappa值=0.770,P<0.001)。结论骨质疏松性椎体骨折疼痛部位与骨折部位不一致性较高,对疑似骨质疏松性骨折的老年腰背部疼痛患者,应行包括胸、腰椎的X线检查,以免误诊或漏诊。更多还原

【Abstract】 Objective To evaluate the consistency between osteoporotic vertebral fracture sites and pain location.Methods Clinical data and X-ray films of 128 osteoporotic vertebral fracture(T8～L4) patients were analyzed.Injury history,fracture sites were recorded.VAS was used for evaluating pain degreed and Kuorinka for depicting pain location.The reliability coefficient(Cohen’s Kappa) was calculated between the subjective pain location and the radiological vertebral fracture sites.Results No significant difference was found in gender,age,and injury history(P >0.05).VAS for thoracic fracture scores were higher than that of lumbar fracture(P <0.001).Upper back pain was complained in 15 of 58 cases in thoracic vertebral fracture group and the relationship between fracture sites and pain location was weak(Kappa coefficient=0.031,P =0.290).Forty five of forty seven cases complained with low back pain in lumbar fracture group and there was a strong relationship between fracture sites and pain location(Kappa coefficient=0.770,P <0.001).Conclusion There is a strong inconsistency between fracture sites and pain location in osteoporotic vertebral fracture;comprehensive X-ray examination should be performed regularly in elder upper and low back pain patients suspected with osteoporotic fracture,to avoid misdiagnosis or underdiagnosis.更多还原